Updates in the Evaluation of Older Women with Pelvic Floor Disorders
Purpose of Review
Pelvic floor disorders (PFDs) are common among older women, and pose a unique challenge to the healthcare provider. The onset of PFDs in older women is gradual resulting from an inter-related process of anatomic, hormonal, and functional changes that occur over time and often impacted by concomitant medical co-morbid conditions. In this evidenced-based review, we provide an update on the epidemiology and provide an evidence-based approach to the evaluation of women with PFDs with a specific focus on the impact of aging.
Physical function impairment is prevalent among older women with pelvic floor symptoms. The decline in physical function is likely the consequence of global changes in skeletal muscle health with aging, but may uniquely impact the pelvic floor muscle physiology and function.
Providers caring for older women with PFDs must account for the impact of the aging process on symptom presentation and evaluation.
KeywordsUrinary incontinence Evaluation Aging Older women
Compliance with Ethical Standards
Conflict of Interest
Candace Parker-Autry and Jubilee Tan declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
- 4.English E, Rogo-Gupta L. Impact of distance to treatment center on care seeking for pelvic floor disorders. Female pelvic medicine & reconstructive surgery. 2017;Google Scholar
- 5.Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.CrossRefGoogle Scholar
- 14.Dua A, Radley S, Jones G, Farkas A. The personal impact of pelvic floor symptoms and their relationship to age. Int Urogynecol J. 2014;25(1):117–21. A prospective study evaluating pelvic floor symptoms among young and older community-dwelling women utilizing validated questionnaires to determine bother and impact of quality of life CrossRefGoogle Scholar
- 18.Pizarro-Berdichevsky J, Clifton MM, Goldman HB. Evaluation and management of pelvic organ prolapse in elderly women. Clin Geriatr Med. 2015;31(4):507–21. A comprehensive review of pelvic organ prolapse staging of severity, symptom profile, physical examination diagnosis, and management options CrossRefGoogle Scholar
- 21.Wagg A, Chen L, Kirschner-Hermanns R, et al. Incontinence in the frail elderly In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence ICUD-EAU 2013. p. 1001–100.Google Scholar
- 46.Bliss DZ, AM, Whitehead WE, et al. Assessment and conservative management of faecal incontinence and quality of life in adults In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Incontinence ICUD-EAU 2013. p. 1443–86.Google Scholar
- 52.Wagg A, Gibson W, Ostaszkiewicz J, Johnson T 3rd, Markland A, Palmer MH, et al. Urinary incontinence in frail elderly persons: report from the 5th International Consultation on Incontinence. Neurourol Urodyn. 2015;34(5):398–406. Evidence-based guidelines for the management of frail older persons with urinary incontinence CrossRefGoogle Scholar
- 56.Kunkle CM, Abernethy MG, Van Tongeren LR, Fashokun TB, Wright EJ, Chen CC. Prevalence of cognitive impairment in older women with pelvic floor disorders. Int Urogynecol J. 2017.Google Scholar
- 57.Bo K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Neurourol Urodyn. 2017;36(2):221–44.CrossRefGoogle Scholar
- 61.Giri A, Hartmann KE, Hellwege JN, Velez Edwards DR, Edwards TL. Obesity and pelvic organ prolapse: a systematic review and meta-analysis of observational studies. Am J Obstet Gynecol. 2017;Google Scholar