Surgical treatment for pelvic floor disorders in women 75 years or older: a single-center experience.
OBJECTIVE
Older patients are usually regarded as suboptimal candidates for surgical operations, particularly in cases of reparative, non-life-saving procedures. The aim of this study was to analyze the feasibility and safety of surgical treatment for pelvic floor dysfunction in advanced-age women.


METHODS
A single-center descriptive study was performed through a retrospective medical records review. Women 75 years or older who underwent a surgical operation for urogynecological dysfunction (pelvic organ prolapse, urinary incontinence, or both) between January 2000 and December 2009 were considered.


RESULTS
Overall, 138 women were included. Median age was 77 years (range, 75-95 y). Women underwent different types of surgical correction. The following procedures (alone or in combination) were performed: 102 (73.9%) vaginal hysterectomies, 106 (76.8%) anterior repairs, 36 (26%) posterior repairs, 9 (6.5%) colpocleisis, 4 vaginal vault ileococcygeus suspensions (2.9%), and 22 (15.9%) tension-free vaginal tape procedures. One (0.7%) intraoperative and five (3.6%) postoperative complications occurred. Urinary retention rate after surgical operation was 5.8%. Only one (0.7%) woman was discharged with a Foley catheter because of voiding difficulty. Clinical follow-up showed 87.6% anatomical success in women with genital prolapse and a subjective success rate of 86.4% in women undergoing anti-incontinence procedures.


CONCLUSIONS
Our study shows that reconstructive surgical operation is a viable treatment option for pelvic floor dysfunction in older patients.
Ghezzi
Fabio
F
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. fabio.ghezzi@uninsubria.it
Uccella
Stefano
S
Cromi
Antonella
A
Bogani
Giorgio
G
Candeloro
Ilario
I
Serati
Maurizio
M
Bolis
Pierfrancesco
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D007431:Intraoperative Complications / Q000453:epidemiology; D017773:Pelvic Floor; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D053825:Suburethral Slings / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000601:surgery*; D016055:Urinary Retention / Q000453:epidemiology; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data