Upright Open MRI (MRO) Evaluation of the Anatomic Effects of Yoga Postures on the Bladder Neck and Urethra

<b>Background/Objectives</b>: Upright open magnetic resonance imaging allows the impact of posture and gravity to be evaluated. Randomized controlled trials of yoga for treating urinary incontinence (UI) in women show significant clinical benefit, yet the anatomic impact of this therapy on the lower urinary tract remains unelucidated. This study tested the hypothesis that open MRI scans can be obtained with sufficient detail to visualize the bladder neck and urethra. <b>Methods</b>: We scanned a volunteer subject using a 0.5 Tesla MRO Open Evo scanner to obtain axial and sagittal T2-weighted pelvic scans during poses used in yoga therapy. To obtain images with the necessary detail, we employed variations in sequencing during scanning of each individual pose. The changes observed in the bladder neck and urethral outline in each pose were then compared to baseline supine images. <b>Results</b>: Images with sufficient anatomic detail were obtained in each of the four poses studied. These scans identified that the urethral outline changes anatomically based on the posture adopted and is dynamic with regional alternations evident in caliber during specific yoga poses. <b>Conclusions</b>: Open MRI can identify anatomical changes involving the bladder neck and urethra that occur during yoga poses used in the treatment of UI in women; these likely relate to effects of posture and gravity. Open MRI offers a way to elucidate the anatomic effects that specific yoga poses generate and to identify those with the potential to be most beneficial clinically to women as a form of therapy.