Abstract
This study investigated age-related anatomical changes in female pelvic structures using magnetic resonance imaging (MRI), aiming to identify factors contributing to pelvic floor dysfunction. This was a retrospective cross-sectional study including pelvic MRI data from 120 asymptomatic women (aged 15-74 years), divided into 6 age groups at 10-year intervals. Measured parameters included pubic symphysis inclination angle, anterior bladder space area, puborectal muscle pinch angle, and rectovaginal-anal levator gap area. All parameters demonstrated significant age-related trends. The pubic symphysis inclination angle increased progressively, reaching its highest mean value in women aged 65 to 74 years (51.8° vs 41.2° in the 15-24 group, P < .05). The anterior bladder space area was significantly larger in women ≥45 years (mean 7.9 cm²) compared with those <45 years (mean 5.1 cm², P < .05). The puborectal muscle pinch angle was greatest in the youngest group (mean 91.3° in 15-24 vs 83.7° in older groups, P < .05). The rectovaginal-anal levator gap area expanded notably in the 65 to 74 group (2.3 cm² vs 1.5 cm² in younger groups, P < .05). Correlation analysis confirmed positive associations between all parameters and advancing age. Progressive age-related changes in pelvic anatomy and musculature may predispose women to pelvic floor dysfunction, particularly pelvic organ prolapse. Quantitative MRI provides objective markers for early detection of pelvic floor weakening and may serve as a valuable tool for screening and monitoring in middle-aged and elderly parous women to guide timely preventive interventions.