Global pelvic floor descent during evacuation

Case contributed by Vikas Shah
Diagnosis probable

Presentation

Mixed stress and urge urinary incontinence. Vaginal discomfort. Difficult defecation.

Patient Data

Age: 35 years
Gender: Female

Structural findings:

Dynamic findings:

Case Discussion

The presence of the TVT reflects a previous attempt at treating the stress urinary incontinence. However there is marked descent of the urinary bladder on evacuation, and this with the change in urethral angle are anatomical changes that contribute to stress incontinence. There is also rectal descent along with a rectocele. The imaging findings can explain all of the symptoms.

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