Strengths and limitations
Maintaining normal anatomical appearances in situ is a prerequisite for
well-functioning pelvic organs. Pelvic organ prolapse (POP) mostly
occurs in the upper two-thirds of the vagina. Although the vaginal shape
and dimensions have been previously studied16, the
method used to evaluate this part of the vagina in situ is seldom
reported but could be of great clinical value. This study is the first
to attempt to introduce a line for an in situ evaluation of the upper
two-thirds of the vagina on MRI.
Limitations exist in our study. First, this study adopted a
retrospective cross-sectional design; the clinical examinations were not
always performed by experienced physicians familiar with POP
quantification. Second, not all patients had a transabdominal or
laparoscopic surgical record, which was important for identifying dense,
extensive adhesions between the pelvic and abdominal walls that may
potentially change the direction of the vagina. Finally, MRI was
conducted in the supine position in all patients in this study; thus,
the results may not reflect pelvic organ positions in the standing
position17.