Do repetitive Valsalva maneuvers change maximum prolapse on dynamic MRI?

Julie A. Tumbarello, Yvonne Hsu, Christina Lewicky-Gaupp, Suzan Rohrer, John O L DeLancey

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Introduction and hypothesis: This study seeks to quantify differences in anterior vaginal wall prolapse during sequential Valsalva attempts on dynamic magnetic resonance imaging (MRI). Methods: Subjects were taken from an on-going case-control study evaluating anterior vaginal wall prolapse. Women with a prolapse whose leading edge extended ≥1 cm beyond the hymenal ring were included (n=40). All subjects performed three maximal Valsalva efforts while mid-sagittal dynamic MRI scans were obtained. Bladder descent between the first, second, and third maximal Valsalva efforts were compared. Results: Forty percent of women had a greater than 2-cm increase in prolapse size from their first to third Valsalva attempt. Ninety-five percent of women extended their prolapse further with a third Valsalva. Conclusions: As is true during clinical examination, several attempts may be required to have maximal anterior compartment prolapse present during dynamic MRI of the pelvic floor.

Original languageEnglish (US)
Pages (from-to)1247-1251
Number of pages5
JournalInternational Urogynecology Journal
Issue number10
StatePublished - Oct 2010


  • Magnetic resonance imaging
  • Pelvic organ prolapse
  • Valsalva

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynecology


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