Incontinence surgery in the older woman.
OBJECTIVE
To review recently published studies on stress urinary incontinence surgery outcomes in older women.


RESULTS
Five prospective and two retrospective studies were identified that reported tension-free vaginal tape (n = 6), colposuspension (n = 1) and cadaveric fascia transvaginal sling (n = 1) procedure results. In each study, 21-175 older women were included, with mean ages ranging from 71 to 83 years; most studies included younger comparison groups. Mean follow-ups ranged from 3 to 30 months. Subjective stress urinary incontinence 'cure/improvement' rates after surgery were significantly lower in older women when compared with younger women in only one study, although similar trends were seen in two additional studies. Intraoperative complications occurred at similar rates in older and younger women. Postoperative complications (urinary tract infection, urgency, voiding dysfunction, and mesh erosion) were more common in older women in only a few studies.


CONCLUSIONS
Recent studies demonstrate that surgery for stress urinary incontinence in older women improves symptoms, although in some reports, not to the extent seen in younger women. It is unclear if some postoperative complications are more common in older women undergoing incontinence surgery. Results from randomized trials focusing on stress urinary incontinence surgery in older women are needed.
Sharp
Victoria J
VJ
Department of Urology, University of Iowa, Iowa City, Iowa 52242-1089, USA.
Bradley
Catherine S
CS
Kreder
Karl J
KJ
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000473:pathology / Q000601:surgery*; D013520:Urologic Surgical Procedures