Fecal incontinence in the postreproductive woman

Magnetic resonance imaging (MRI) of the pelvic floor specifically to evaluate causes of fecal incontinence is relatively new. Along with physical examination and endoanal ultrasound, recently developed MRI techniques can be used to more accurately diagnose and characterize pelvic floor disorders leading to fecal incontinence. All three compartments of the pelvic floor can be evaluated simultaneously using MRI. During an MRI study, images are rapidly obtained in the sagittal plane at rest and during strain, and in the axial plane at rest. In symptomatic patients, abnormal descent of pelvic viscera is indicative of muscle or fascial weakness. Abnormal descent of pelvic viscera is readily detected on sagittal MR images. Muscle and sphincter tears can also be visualized, although most fascial damage is incurred secondarily. The detailed information gained from an MRI can be used to plan optimal treatment, surgical or otherwise.