 Hello, good evening to all, myself Dr. Nishant Nusra. I am a PG, second day NPG, I am a Swohtak. I am presenting the poster on Urvesana pelvic floor dysfunction in a patient with fissure line, you know, fissure line, you know, basically perianal fissure, it is a abnormal track communicating with the anal canal or rectum and perianal skin. It is a common clinical condition with a prevalence of approximately one per 10,000 is affected predominantly young adults in their fourth decades of life. Men are affected to a four times more commonly than women. The region talks to possibly higher evidence of an Anglian in men. Perianal fissure may be caused by several inflammatory condition and events including Crohn's disease, pelvic infection, tuberculosis, divertculosis, trauma, trauma during childbirth, pelvic malignancy and radiation therapy. However, most are idiopathic and are generally taught to be present the chronic phase of intramuscular anal gland sepsis. The pelvic floor dysfunction is an umbrella term for a heterogeneous group of disordered affecting 50% of the middle age and old Paris women presenting with pelvic pain, pressure, dysparinia and incontinence in complete emptying and gross organ protrusion. Although pelvic floor disease are relatively common, their development is complex and multifactorial. The greatest risk factor for these condition is a female sex. Other risk factor include increasing age, parity, prior pelvic surgery and chronic increase in triabdominal pressure. Fiscalization is a common clinical condition with the cause significant mobility and because despite surgical treatment more ever present as well as surgeon remain unaware of the associated pelvic floor dysfunction at it is more common in females which may lead to persistent post-operative symptoms in the patient. Therefore, we conducted a detailed study of the relationship between pelvic floor dysfunction and perianal disease. Imaging techniques we use MRI because it is non-invasive modality that allow dynamic innovation of all pelvic organ in the multiplanes with high soft tissue regulation and without use of emerging radiation. We also use static MR imaging in utilize to delineate components of pelvic organ support system including the inner specter complex, dynamic MR imaging with fast sequence enables functions evaluation to assess pelvic floor relaxation and descent. It is also the golden standard, gold standard modality for preoperative evaluation and classification of perianal tissue because of its ability to directly visualize the traits and access with high soft tissue regulation. The aim and objectives of the my study is to elevate in-automical and functional changes in the pelvic floor in a patient with fistula or imaging. The study to relationship between the grading of the perianal fistula with pelvic floor dysfunction. We use patient with clinically diagnosed perianal fistula where included in the study, patient with previously operated or partially treated patient of perianal fistula, contraindication to MRI, history of linear inflection, clinical evidence of prostateitis, clinical evidence of sexual distance or any psychological problems were excluded. We use 3-tesla imaging and after placing the patient on lateral decubitus position on a scanner table, 120 to 200 cc of a worm ultrasound gel introduced into rectum through a flexible catheter. The dynamic study will perform concessing of resting, straining and defecation phase in addition to usual sequence of pelvis assessment. We use the parameter for this on the base of gyms in our city hospital classification. We use grade 0 for normal appearance, grade 1 for simple linear intracerectal fistula, grade 2 for intracerectal fistula with intracerectal abscess or secondary fistula tract. Grade 3 for trans-systnetic fistula, grade 4 for trans-systnetic fistula with abscess or secondary tract within the osteoenol or vesture rectal fascia. Grade 5 for supra-elevator and trans-elevator DGE is in addition to this we following parameters are also used like as line 4, that is levator hattus, M-line, enorectal angle, levator plate, organ prolapse and the observation of my study is that there is for grade 1 there is 30% percent, for grade 2 there is 19% percent, for grade 3 there is 5% percent and in grade 4 there is 10% percent, in grade 5 there is 36% percent. And the comparison of all cases we see that high-tel enlargement seen in 35%, pelvic floor descent seen in 30% and normal enorectal angle seen in 24% and normal levator plate angle seen in 5%, abscess seen in 7%, number of secondary tract seen in 3%, cystosil seen in 2%, rectosil seen in 2%. We compare the fistula and pelvic floor dysfunction, we see high-tel enlargement pelvic floor descent and normal enorectal and levator plate angle were noted more in percent with active fistula as compared to inactive fistula, complex fistula, fistula were usually active fistula, so more cases with abnormal levator plate angle as compared to simple fistula, percentage of patient with high-tel enlargement was more in grade 1 fistula while pelvic floor descent abnormal levator plate and enorectal angle was more pronounced in grade 5 fistula. We see a 34-year-old male presented with perianal discharge and pain for two years, imaging so supra-leavator grade 5 fistula with pelvic floor dysfunction. This is another, there is a figure E1, E2, E3, we see deficit pubic oxygel lines, S-line and M-line in restening and staining and defecation phase respectively, there is a high-tel enlargement and pelvic floor descent noted in defecation phase finding is suggestive of pelvic floor dysfunctions and this is a figure 3, in figure 3, there is 3, F1, F2, F3 demonstrated enorectal angle banding in restening staining and defecation 4 in figure 4, levator plate angle so in G1, G2, G3 imaging during restening staining and defecation phase respectively. And this is another case, there is 49-year-old female presented with complain of perianal discharge and itching for 8 months, imaging revealed to create one fistula with eminence of cystosil and this is last image we see the 26-year-old female presented with complain of perianal discharge and itching for 1.5 years, imaging so great one fistula with eminence of rectosil, thank you, thank you very much.