Prolapse and Incontinence Surgery in Older Women

Purpose

Pelvic floor disorders including urinary incontinence, pelvic organ prolapse and fecal incontinence are common problems encountered by the older woman. With the increasing population of older American women urologists and gynecologists can expect to provide evaluation and treatment of these conditions with increasing frequency. These conditions are amenable to medical and surgical therapies.

Materials and Methods

Contemporary articles (2003 to the present) that included older women undergoing urogynecological surgery were included in this review. Current data on morbidity, mortality and/or surgical outcomes are presented with evidence based preoperative, intraoperative and postoperative surgical management strategies.

Results

Older women undergoing pelvic floor surgery can expect operative risks as well as subjective and objective anatomical and quality-of-life outcomes similar to those of younger women.

Conclusions

The decision for surgical intervention for the treatment of pelvic floor disorders should not be based on chronological age alone. Before selecting a specific surgical procedure, all existing pelvic floor defects should be evaluated. Further research is required to understand the impact that surgery for pelvic floor disorders has on anatomical, physiological and functional outcomes in older women.

Key Words: geriatrics, pelvic floor, prolapse, urinary incontinence

Abbreviations and Acronyms: ASC, abdominal sacral colpopexy, DVT, deep venous thrombosis, FI, fecal incontinence, MI, myocardial infarction, POP, pelvic organ prolapse, RCT, randomized, controlled trial, SUI, stress urinary incontinence, TVT, tension-free vaginal tape, UI, urinary incontinence, USS, uterosacral suspension, UTI, urinary tract infection