Preliminary Diagnosis: Cystocele
I. What imaging technique is first-line for this diagnosis?
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Fluoroscopic guided voiding cystourethrogram.
II. Describe the advantages and disadvantages of this technique for diagnosing cystocele.
Advantages
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Highly portable imaging modality.
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Highly sensitive and less specific in detailing and diagnosing a cystocele.
Disadvantages
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May expose patients to large amounts of ionizing radiation.
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Less adept in detailing the surrounding anatomical structures than other imaging modalities.
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Highly operator dependent.
III. What are the contraindications for the first-line imaging technique?
Contraindicated in pregnant patients.
IV. What alternative imaging techniques are available?
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Dynamic contrasted MR imaging
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Ultrasound
V. Describe the advantages and disadvantages of the alternative techniques for diagnosing cystocele.
Dynamic contrasted MR imaging
Advantages
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Does not expose patients to ionizing radiation.
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Offers more exquisite detail of the surrounding anatomical structures than other imaging modalities.
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Sensitive and specific in detailing and characterizing the primary abnormality and characterizing any secondary complications.
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Offers the best visualization of the pelvic floor and helps characterize and detail the surrounding anatomical structures.
Disadvantages
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Expensive.
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Time consuming.
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Requires significant patient cooperation to minimize motion artifact.
Ultrasound
Advantages
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Does not expose patients to ionizing radiation.
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Highly portable.
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May be used to guide treatment.
Disadvantages
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Highly operator dependent.
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Less adept in detailing the surrounding anatomical structures.
VI. What are the contraindications for the alternative imaging techniques?
Dynamic contrasted MR imaging
May be contraindicated in patients with non-MR compatible hardware.
Ultrasound
None.
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