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Purpose Patientswithsevereanteriorvaginalwallprolapseareinclinedtodemonstratedenovostressurinaryincontinence(SUI) afterpelvicfloorrehabilitation.ThisstudyaimtoinvestigatetheroleofstaticanddynamicMRIinpredictingoccultSUIpreoperation. Methods and Materials 47patientswithsevereanteriorvaginalwallprolapsebutwithoutcomplainingofSUIwereenrolled. PreoperativelystaticanddynamicMRexaminationofpelvicfloorwereperformedwithprolapsereduction.Urethralsphincter dysfunctionwasindicatedwhenwidenofproximalurethraandfunnelingattheurethrovesicaljunctionwereobserved.Urethral mobilitywasdefinedbyrotationofurethra.Vesicalneckmovementwasevaluatedbyitsdistancetopubococcygealline(PCL).A publishedlevatoranimuscle(LAM)scoringsystemwasusedtocharacterizemorphologicalchangesofLAManddividedthe severityofinjuryintothreecategoriesasnone,minorandmajor.PrimaryoutcomewasdenovoSUIat1yearpostoperative follow-upbyanexperiencedgynecologist. Results Ofthe47patients,5cases(10.6%)demonstrateddenovoSUIpostoperatively.Urethralsphincterdysfunctionand funnelingwerepresentinallofdenovoSUIpatientswhilstonly7.14%incontinentpatients.DenovoSUIpatientswerehaving moreminorbutnotmajorLAMdefectsthancontinentpatients,bothinpuborectalmuscle(minor40.0%vs.21.4%,major60.0% vs.50%;P=0.06)andiliococcygealmuscle(minor80.0%vs.33.3%,major20.0%vs.19.0%;P=0.33).Thevalueofvesicalneck downwardmovementmeasuredindenovoSUIpatientswasmorethanincontinentpatients(23.4±16.4vs.19.9±11.4,P=0.06) thoughwithoutsignificantdifference.UrethralmobilitywasequallyactiveindenovoSUIpatientsandcontinentpatients(50.8±32.4vs.50.4±26.1,P=0.46). Conclusion TheurethralsphincterdysfunctionandfunnelingcanbetreatedasapracticalindicatorofoccultSUIpre-operation forpatientswithsevereanteriorvaginalwallprolapse,especiallywhencombinedwithmoreminorLAMinjuryandmoreactive vesicalneckdownwardmovement.