Role of magnetic resonance defecography in the assessment of obstructed defecation syndrome

Figure 5 Urethral hypermobility and cystocele. A: Sagittal true fast imaging with steady-state free precession (TRUFI) at rest, which shows minimal posterior angulation of the urethra (yellow line), approximately 5° relative to the vertical axis of the pubis; B: In the sagittal TRUFI image obtained during the defecation phase, the urethral axis rotates posteriorly to 162° and descends below the pubic symphysis, indicating urethral hypermobility. This is accompanied by a descent of the bladder neck below the pubococcygeal line, consistent with cystocele.