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Abstract Pelvic floor dysfunction, which includes muscular pelvic floor relaxation and pelvic organ prolapse, can lead to a range of symptoms including pelvic pain, incontinence, constipation, or a bulging perineal mass. The surgical approach, as well as its ultimate success, depends on identifying all involved compartments and accurately staging severity. For evaluation of these disorders, several imaging techniques may be used to supplement physical examination findings in patients with suspected pelvic floor dysfunction. Traditionally, fluoroscopic methods, including cystoure-thrography and evacuation proctography, have formed the cornerstone of the imaging evaluation. However, these techniques require ionizing radiation, are uncomfortable and time consuming for patients, and can assess only one compartment at a time. Sonography is operator dependent, has poor soft-tissue contrast, a limited field of view, and can be difficult to perform dynamically for the evaluation of changes with maneuvers such as the Valsalva maneuver. Dynamic MRI offers a non-invasive alternative with no ionizing radiation and has several advantages for the evaluation of pelvic floor disorders including a large field of view, soft-tissue contrast superior to that of sonography, direct multi-planar capability. Although MRI is currently the best available technique for evaluation of prolapse, upright dynamic MRI in an open configuration magnetic resonance system or even three- dimensional reconstruction for virtual reality of the urinary tract and pelvic floor might be used in the future for evaluation of pelvic floor dysfunction. |