title: Personalizing pelvic floor reconstructive surgery in aging women.
abstract: Pelvic floor dysfunction is a growingly frequent condition in aging individuals. Urinary or rectal incontinence, constipation, pelvic organ prolapse, pelvic pain or sexual dysfunction are common problems in this age range. Such conditions carry a severe impact on quality of life, but also limit individual independence in daily activities, favor social isolation and carry health risks. Diagnosis and treatment of pelvic floor dysfunction in aging women is tricky, since multiple interfering conditions affecting muscle tone and nerve function are common in these individuals. Diabetes mellitus, sarcopenia, use of drugs that affect cognition or impact bowel or urinary function are just a few examples. These conditions need to be thoroughly taken into account during pre-operative work up for their potential impact on the success of surgery and vice versa. Functional reconstruction aimed at treating symptoms rather than anatomic defects is key to success. The recent advancements in surgical treatment of urinary incontinence and pelvic organ prolapse allow for more options to achieve the best surgery in each patient.
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mannella
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giannini
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Russo
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Naldini
authors.affiliation: Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, University of Pisa, Via Roma, 67, 56126 Pisa, Italy. Electronic address: tommaso.simoncini@med.unipi.it.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Simoncini
mesh_terms: D000375:Aging / Q000502:physiology; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000503:physiopathology / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000503:physiopathology / Q000601:surgery*; D057285:Precision Medicine; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000601:surgery*
keywords: Ageing; Menopause; Pelvic organ prolapse; Personalized surgery; Reconstructive surgery; Urinary incontinence