ORIGINAL ARTICLE Magnetic resonance imaging of abdominal versus vaginal prolapse surgery with mesh Shimon Ginath & Alan D. Garely & Jonathan S. Luchs & Azin Shahryarinejad & Cedric K. Olivera & Sue Zhou & Charles J. Ascher-Walsh & Alexander Condrea & Michael L. Brodman & Michael D. Vardy Received: 5 January 2012 / Accepted: 25 March 2012 / Published online: 28 April 2012 # The International Urogynecological Association 2012 Abstract Introduction and hypothesis We compared two surgical approaches in patients with symptomatic prolapse of the vaginal apex with normal controls by analyzing pelvic land- mark relationships measured using magnetic resonance imaging (MRI) before and after surgery. Methods In this prospective multicenter pilot study involving 16 participants, nulliparous controls (n 0 6) were compared with ten parous (3.0±1.0) women with uterine apical prolapse equal to or greater thanstage 2. Group A (n 0 5) underwent abdominal sacral colpopexy with monofilament polypropyl- ene mesh and group B (n 0 5) with vaginal mesh kit repair (Total ProLift). Subtotal hysterectomy was performed in all group A and no group B women. All patients underwent preoperative and 3-month postoperative Pelvic Organ Pro- lapse Quantification (POP-Q) and dynamic MRI. Comparison of MRI pelvic angles and distances was performed and ana- lyzed by Mann–Whitney rank sum test and chi-square test. Results Vaginal apical support is similar at 3 months for abdominal sacral colpopexy (ASCP) and ProLift by POP-Q examination and MRI analysis. In both treatment groups, the postoperative POP-Q point C and MRI parameters were similar to nulliparous controls at 3 months. Conclusions Anatomic outcomes for ASCP compared with ProLift were similar at 3 months in terms of vaginal apical support by POP-Q and MRI analysis. Continued compara- tive analysis of postoperative support with objective imag- ing seems warranted. Keywords Abdominal sacral colpopexy . Monofilament polypropylene mesh . ProLift . Pelvic organ prolapse . Magnetic resonance imaging Abbreviations POP Pelvic organ prolapse ASCP Abdominal sacral colpopexy VSCP Vaginal sacrospinous colpopexy MRI Magnetic resonance imaging MPM Monofilament polypropylene mesh POP-Q Pelvic Organ Prolapse Quantification S. Ginath : A. Shahryarinejad : C. K. Olivera : S. Zhou : C. J. Ascher-Walsh : M. L. Brodman : M. D. Vardy Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA S. Ginath : A. D. Garely : A. Shahryarinejad : C. K. Olivera : S. Zhou Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, NY, USA S. Ginath : A. Shahryarinejad : C. K. Olivera : S. Zhou : M. D. Vardy Department of Obstetrics and Gynecology, Englewood Hospital and Medical Center, Englewood, NJ, USA S. Ginath : A. Condrea Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel-Aviv, Israel J. S. Luchs Department of Radiology, Winthrop University Hospital, Mineola, NY, USA S. Ginath (*) Department of Gynecology and Obstetrics, E. Wolfson Medical Center, P.O. Box 5, Holon 58100, Israel e-mail: ginath@gmail.com Int Urogynecol J (2012) 23:1569–1576 DOI 10.1007/s00192-012-1783-2