Evaluation of Treatment for Pelvic Organ Prolapse in Patients Aged 85 Years and Older

<p>Among the rapidly aging population in Japan, the number of older patients with pelvic organ prolapse (POP) is also increasing. We retrospectively studied the background and treatment outcomes of POP patients aged ≥ 85 years at our hospital. During the 3-year period from April 2019 to March 2022, 927 patients with POP visited our hospital, of whom 78 (8.4%) were ≥ 85 years old. Thirty-four patients (44%) had POP-Quantification stage 3 and 29 (37%) had stage 4 prolapse. Twenty two patients (28%) underwent surgical treatment because conservative treatment with a vaginal pessary was not feasible (17 with colpocleisis and 5 with transvaginal mesh surgery). Comorbidities in these surgical patients included hypertension, diabetes, heart disease, renal dysfunction, deep vein thrombosis, and psychiatric disorders . The median postoperative hospital stay was 4 (1-8) days, and no serious intraoperative or postoperative complications occurred. There was no postoperative recurrence, and Prolapse Quality of Life scores improved significantly in all categories. The POP-Q stage of the POP patients aged ≥ 85 years in our hospital is high, with all patients at stage 3 or higher, and when conservative management was difficult, surgical treatment was selected, with good outcome. Surgical treatment can be considered for very old patients with POP if appropriate evaluation and perioperative management of their general condition and comorbidities can be performed and may contribute to improvement of quality of life. This retrospective observational study evaluated outcomes in POP patients aged 85 years and older.</p>