Major reconstructive surgery for pelvic organ prolapse in elderly women, including the medically compromised

Abstract

Objective: To demonstrate the safety of performing extensive pelvic surgery for benign disease in elderly patients, many with significant chronic medical conditions.

Study design: Thirty-four consecutive women over the age of 65 and many with significant chronic medical illnesses underwent extensive pelvic reconstructive surgery in a major teaching hospital. The same attending surgeon, in conjunction with several different chief residents in obstetrics and gynecology, performed all the procedures between November 1998 and December 2001. A variety of procedures for the correction of significant, symptomatic pelvic organ prolapse were utilized. Intra-operative, postoperative, immediate and, when possible, extended outcomes were analyzed.

Results: There were no instances of intraoperative or postoperative mortality or of major intraoperative morbidity. Major postoperative morbidity was uncommon and totally correctable. The vast majority of patients achieved immediate and long-term satisfactory relief of their symptoms.

Conclusion: Extensive pelvic reconstructive surgery is safe and effective in the elderly, regardless of concomitant medical conditions. It is important that patients, primary care physicians and, in some cases, gynecologists be made aware of this fact so that this ever-expanding segment of the population not be denied treatment for the very distressing and often debilitating symptoms of pelvic organ prolapse.