Abstract
Purpose
We investigated the morbidity in elderly patients undergoing surgery due to pelvic organ prolapse.
Methods
Perioperative data of 113 patients aged at least 50 years who underwent gynaecological prolapse surgery between 2005 and 2011 were analyzed retrospectively. Forty-eight women were older than 70 years and matched our inclusion criteria. Sixty-five patients aged 50–69 years undergoing similar surgical procedures during the same period of time formed the control group. Operating time, duration of hospital stay, intra- and postoperative complications, comorbidity, and body mass index were evaluated.
Results
There were no significant differences between study and control collective regarding operating time, duration of hospital stay, intra- and postoperative complications, and body mass index although a significant difference could be notified between the pre-existing comorbidity.
Conclusion
Surgery due to a pelvic organ prolapse in patients aged more than 70 years is a feasible and save treatment to improve quality of life in elderly patients.
Similar content being viewed by others
References
Eisenmenger M, Pötsch O, Sommer B (2009) 11. Koordinierte Bevölkerungsvorausberechnung. Statistisches Bundesamt
Tabata T, Yamawaki T, Ida M, Nishimura K, Nose Y, Yabana T (2001) Clinical value of dilatation and curettage for abnormal uterine bleeding. Arch Gynecol Obstet 264(4):174–176
Hornemann A, Kamischke A, Luedders DW, Beyer DA, Diedrich K, Bohlmann MK (2010) Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women. Arch Gynecol Obstet 281(1):59–64
Nieminen K, Heinonen PK (2001) Sacrospinous ligament fixation for massive genital prolapse in women aged over 80 years. BJOG 108:817–821
Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506
Smith FJ, Holman CD, Moorin RE, Tsokos N (2010) Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol 116:1096–1100
Schweitzer KJ, Vierhout ME, Milani AL (2005) Surgery for pelvic organ prolapse in women of 80 years of age and older. Acta Obstet Gynecol Scand 84:286–289
Leung KY (2007) Changing pattern of hysterectomies for benign conditions. Hong Kong Med J 13:176–177
Edozien LC (2005) Hysterectomy for benign conditions. BMJ 330:1457–1458
Miller KL (1997) Operating on the elderly woman—what are her special needs? Curr Opin Obstet Gynecol 9:300–305
Sevelda P, Vavra N, Kucera H, Grunberger W (1986) Surgical gynecologic interventions in females over 75 years of age. Geburtshilfe Frauenheilkd 46:520–523
Kemeny MM (2004) Surgery in older patients. Semin Oncol 31:175–184
Morel P, Egeli RA, Wachtl S, Rohner A (1989) Results of operative treatment of gastrointestinal tract tumors in patients over 80 years of age. Arch Surg 124:662–664
Spivak H, Maele DV, Friedman I, Nussbaum M (1996) Colorectal surgery in octogenarians. J Am Coll Surg 183:46–50
Boyles SH, Weber AM, Meyn L (2003) Procedures for pelvic organ prolapse in the United States, 1979–1997. Am J Obstet Gynecol 188:108–115
Brown JS, Waetjen LE, Subak LL, Thom DH, Van den Eeden S, Vittinghoff E (2002) Pelvic organ prolapse surgery in the United States, 1997. Am J Obstet Gynecol 186:712–716
Nusbaum NJ (1996) How do geriatric patients recover from surgery? South Med J 89:950–957
Barrier A, Ferro L, Houry S, Lacaine F, Huguier M (2003) Rectal cancer surgery in patients more than 80 years of age. Am J Surg 185:54–57
Walsh TH (1996) Audit of outcome of major surgery in the elderly. Br J Surg 83:92–97
Jaluvka V, Weitzel HK (1995) The age limit in surgical geriatric gynecology. Zentralbl Gynakol 117:233–236
Sieber CC (2007) The elderly patient—who is that? Internist 48:1192–1194
O’Grady NP et al (2008) Guidelines for evaluation of new fever in critically ill adult patients: 2008 update from the American College of Critical Care Medicine and the Infectious Diseases Society of America. Crit Care Med 36:1330–1349
Meisel M, Muller-Werdan U (2009) Geriatrics 2009. Dtsch Med Wochenschr 134:1354–1356
Chung F, Mezei G, Tong D (1999) Adverse events in ambulatory surgery. A comparison between elderly and younger patients. Can J Anaesth 46:309–321
Jaluvka V, Remy N (1994) Gynecologic interventions in the 10th decade of life. Geburtshilfe Frauenheilkd 54:332–336
Liu LL, Leung JM (2000) Predicting adverse postoperative outcomes in patients aged 80 years or older. J Am Geriatr Soc 48:405–412
Stelzner S, Hellmich G, Koch R, Albert W, Ludwig K (2003) Perioperative risk assessment in surgery: an analysis in 10,395 patients. Zentralbl Chir 128:963–969
Nze PU, Njike C (2008) Is routine preoperative chest X-ray indicated in elderly patients undergoing elective surgery? Niger J Med 17(2):150–152
Menard JP, Mulfinger C, Estrade JP, Agostini A, Blanc B (2008) Pelvic organ prolapse surgery in women aged more than 70 years: a literature review. Gynecol Obstet Fertil 36:67–73
Jaluvka V, Poch G, Weitzel H (2000) Gynecologic surgery in patients 80 years of age or older. Geburtshilfe Frauenheilkd 60:269–272
Fichtner K, Dick W (1997) The causes of perioperative mortality. A trial of the German “CEPOD study”. Anaesthesist 46:419–427
Hightower CE, Riedel BJ, Feig BW, Morris GS, Ensor JE Jr, Woodruff VD, Daley-Norman MD, Sun XG (2010) A pilot study evaluating predictors of postoperative outcomes after major abdominal surgery: physiological capacity compared with the ASA physical status classification system. Br J Anaesth 104:465–471
Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D, Wang W, Schaffer J (2005) Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol 192:795–806
Swift SE (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol 183:277–285
Erata YE, Kilic B, Guclu S, Saygili U, Uslu T (2002) Risk factors for pelvic surgery. Arch Gynecol Obstet 267:14–18
Barber MD, Amundsen CL, Paraiso MF, Weidner AC, Romero A, Walters MD (2007) Quality of life after surgery for genital prolapse in elderly women: obliterative and reconstructive surgery. Int Urogynecol J Pelvic Floor Dysfunct 18:799–806
Carey JM, Leach GE (2004) Transvaginal surgery in the octogenarian using cadaveric fascia for pelvic prolapse and stress incontinence: minimal one-year results compared to younger patients. Urology 63:665–670
Gardner B, Palasti S (1990) A comparison of hospital costs and morbidity between octogenarians and other patients undergoing general surgical operations. Surg Gynecol Obstet 171:299–304
Leung JM, Dzankic S (2001) Relative importance of preoperative health status versus intraoperative factors in predicting postoperative adverse outcomes in geriatric surgical patients. J Am Geriatr Soc 49:1080–1085
Nahhas WA, Brown M (1990) Gynecologic surgery in the aged. J Reprod Med 35:550–554
Ravaglia G, Forti P, Lucicesare A, Pisacane N, Rietti E, Patterson C (2008) Development of an easy prognostic score for frailty outcomes in the aged. Age Ageing 37:161–166
Wong RY, Miller WC (2008) Adverse outcomes following hospitalization in acutely ill older patients. BMC Geriatr 8:10–12. doi:10.1186/1471-2318-8-10
Bojahr B, Tchartchian G, Waldschmidt M, Ohlinger R, De Wilde RI (2011) Laparoscopic sacropexy: a retrospective analysis of the subjective outcome in 310 cases. Obstet Gynecol Int. doi:10.1155/2012/538426
Banerjee C, Noe KG (2011) Laparoscopic pectopexy: a new technique for prolapse surgery for obese patients. Arch Gynecol Obstet 284:631–635
Costantini E, Zucchi A, Lazzeri M, Del Zingaro M, Vianello A, Porena M (2011) Managing mesh erosion after abdominal pelvic organ proplase repair: ten years’ experience in a single center. Urol Int 86:419–423
Wright JD, Lewin SN, Barrena Medel NI, Sun X, Burke WM, Deutsch I, Herzog TJ (2011) Morbidity and mortality of surgery for endometrial cancer in the oldest old. Am J Obstet Gynecol. doi:10.1016/j.ajog.2011.02.067
Conflict of interest
The authors declare that they do not have any conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tuschy, B., Berlit, S., Hornemann, A. et al. Morbidity in elderly women undergoing gynaecological pelvic floor surgery. Arch Gynecol Obstet 285, 1295–1300 (2012). https://doi.org/10.1007/s00404-011-2130-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-011-2130-4