Studies that compared results of pelvic organ prolapse staging in women using dynamic magnetic resonance imaging (MRI) (cine loop obtained at rest, during squeezing, straining and/or defecation) with clinical examination (standard method of gynaecological prolapse staging, preoperative or intra-operative) were eligible for inclusion. Studies had to report on a reference line used to stage the prolapse on dynamic MRI and report on clinical findings of cystocele, rectocele, enterocele, and/or uterine or vaginal vault. Studies that reported only on postoperative gynaecologic examination were excluded.
Included studies assessed healthy asymptomatic women, women with pelvic organ prolapse or compared symptomatic women to healthy controls. Mean age ranged from 22 to 69 years. Most studies used Pelvic Organ Prolapse Quantification (POPQ) for clinical assessment; two studies used modified Baden-Walker assessment and one classified rectal protrusion in the vagina. All studies used MRI of the pelvic floor with women in the supine position.
Two reviewers independently assessed studies for inclusion; disagreements were resolved through discussion.