Bladder and Uterine Prolapse – Upright MRI

Imaging is pretty cool, isn’t it? The primary complaint of patients is that symptoms of pelvic organ prolapse get worse when they stand up. That makes sense, right? There are gravity, positional, and pressure changes. Symptoms may vary, but are often described as “bulge feeling down there” or “I feel like I have a golf ball or bowling ball between my legs”.

Here’s a view of comparing lying down vs. standing vs. standing with straining.

Educational piece for patients: * Due to the anatomy, the uterus can actually “fall” so far down that it can protrude outside of the vagina. The bladder is in a separate space. It can also “fall” and cave toward the vaginal wall, but you can’t see the actual bladder falling (just the vagina bulging). However, it is common that the urethra will also descend down along with the bladder. This can be seen vaginally.

Fancy terms: Bladder Prolapse = Cystocele. Bladder + Urethra = Cystourethrocele

[Left side is the front of the body and the right side is the back/spine. The white part is the bladder and directly to the right is the uterus].

Bladder and Uterus Prolapse in Standing


  1. Pelvic Guru October 11, 2012 at 9:59 am - Reply

    Working on enlarging this picture!

  2. Louise October 15, 2012 at 9:30 am - Reply

    Is this a live woman or a cadaver? Is she really vertical in the second and third pictures? If she is vertical in the second and third pictures, why don’t her buttocks change in shape? They look flattened, as if she is still lying down.

  3. Pelvic Guru October 15, 2012 at 9:43 am - Reply

    Hello Louise- thanks for your question. This is actually a live woman who is standing in the second picture and then actively straining in the third (not cadaver). If you were to draw a line at the bottom near the buttocks, you would see a downward shift of the anatomy there. The MRI is a “cross-section” (cut) view so everything will look more “flattened”. I hope that helps…I totally see why it would look confusing.

  4. incostress April 24, 2013 at 1:26 am - Reply

    Reblogged this on Healthy Solutions and commented:
    Valuable information for women with pop

  5. incostress April 24, 2013 at 1:27 am - Reply

    Valuable information for women suffering pop symptoms

  6. drsimontreissman1 November 10, 2015 at 10:49 pm - Reply

    Very interesting new method to assess female urinary tract affected by stress incontinence.

    Take a look at my recent academic paper entitled: “Upright MRI in the evaluation of genuine stress urinary incontinence of the female urinary tract” on research

    • Pelvic Guru November 10, 2015 at 11:07 pm - Reply

      Thanks for sharing! Please feel free to attach the link here.

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