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Surgical treatment for pelvic floor disorders in women 75 years or older: a single-center experience

Ghezzi, Fabio MD; Uccella, Stefano MD; Cromi, Antonella MD, PhD; Bogani, Giorgio MD; Candeloro, Ilario MD; Serati, Maurizio MD; Bolis, Pierfrancesco MD

doi: 10.1097/gme.0b013e3181f2e629
Original Articles
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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.

From the Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy.

Received May 31, 2010; revised and accepted July 19, 2010.

Stefano Uccella, MD, is currently with the PhD program in Experimental Medicine and Oncology, University of Insubria, Varese.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Fabio Ghezzi, MD, Department of Obstetrics and Gynecology, University of Insubria, Piazza Biroldi, 1 Varese, 21100, Italy. E-mail: fabio.ghezzi@uninsubria.it

©2011The North American Menopause Society