Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 4 , Pages 374-378, December 2007

Pelvic Floor Dysfunction in Aging Women

  • Gin-Den Chen

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Gin-Den Chen, Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, 110, Section 1, Chien-Kuo North Road, Taichung 40201, Taiwan

Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, Taichung, Taiwan

Accepted 14 June 2007.

Article Outline

SUMMARY 

The occurrence of pelvic floor dysfunction may increase steadily during the aging process in women. Pelvic floor dysfunction may be associated with dysfunctions of micturition, defecation, prolapse, and sex. The natural history and mechanism of pelvic floor dysfunction in aged women are not well understood or explored. In this article, we review the effect of age on the prevalence of pelvic floor dysfunction and on the structural and functional changes of the lower urinary tract, anorectum and pelvic floor. Altogether, the aging process has a negative impact on either the function or structure of the lower urinary tract, anorectum and pelvic floor in women.

Key Words:  aging , anal function , elderly , lower urinary tract dysfunction , pelvic floor dysfunction , pelvic floor

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References 

  1. Mant J , Painter R , Vessey M . Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study . Br J Obstet Gynaecol . 1997;104:579–585
  2. Jundt K , Kiening M , Fischer P , et al.   Is the histomorphologi-cal concept of the female pelvic floor and its changes due to age and vaginal delivery correct? . Neurourol Urodyn . 2005;24:44–50
  3. MacLennan AH , Taylor AW , Wilson DH , Wilson D . The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery . BJOG . 2000;107:1460–1470
  4. Ng SC , Chen YC , Lin LY , Chen GD . Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms . Int J Gynaecol Obstet . 2002;77:139–145
  5. Chen GD , Lin TL , Hu SW , Chen YC , Lin LY . Prevalence and correlation of urinary incontinence and overactive bladder in Taiwanese women . Neurourol Urodyn . 2003;22:109–117
  6. Chen GD , Hu SW , Chen YC , Lin TL , Lin LY . Prevalence and correlations of anal incontinence and constipation in Taiwanese women . Neurourol Urodyn . 2003;22:664–669
  7. Hung MJ , Shen PS , Ho ESC , Sun MJ , Lin ATL , Chen GD . Urgency is the core symptom of female overactive bladder syndrome, as demonstrated by a statistical analysis . J Urol . 2006;176:636–640
  8. Chen YC , Chen GD , Hu SW , Lin TL , Lin LY . Is the occurrence of storage and voiding dysfunction affected by meno-pausal transition or associated with the normal aging process? . Menopause . 2003;10:203–208
  9. Stewart WF , van Rooyen JB , Cundiff GW , et al.   Prevalence and burden of overactive bladder in the United States . World J Urol . 2003;20:327–336
  10. Milsom I , Abrams P , Cardozo L , Roberts RG , Thuroff J , Wein AJ . How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study . BJU Int . 2001;87:760–766
  11. Goepel M , Hoffmann JA , Piro M , Rubben H , Michel MC . Prevalence and physician awareness of symptoms of urinary bladder dysfunction . Eur Urol . 2002;41:234–239
  12. Lin TL , Ng SC , Chen YC , Hu SW , Chen GD . What affects the occurrence of nocturia more: menopause or age? . Maturitas . 2005;50:71–77
  13. Haylen BT, Krishnan S, Schulz S, Verity L, Law M, Zhou J, et al. Has the true prevalence of voiding difficulty in urogynecology patients been underestimated? . Int Urogynecol J Pelvic Floor Dysfunct . 2007;18:53–56
  14. Haylen BT , Ashby D , Sutherst J , Frazer MI , West CR . Maximum and average urine flow rates in normal male and female populations—the Liverpool nomograms . Br J Urol . 1989;64:30–38
  15. Whitehead WE , Drinkwater D , Cheskin LJ , Heller BR , Schuster MM . Constipation in the elderly living at home: definition, prevalence, and relationship to lifestyle and health status . J Am Geriatr Soc . 1989;37:423–429
  16. Johanson JF , Sonnenberg A , Koch TR . Clinical epidemiology of chronic constipation . J Clin Gastroenterol . 1989;11:525–536
  17. Malone-Lee JG , Wahedna I . Characterisation of detrusor contractile function in relation to old age . Br J Urol . 1993;72:873–880
  18. Griffiths DJ , McCracken PN , Harrison GM , Gormley EA . Characteristics of urinary incontinence in elderly patients studied by 24-hour monitoring and urodynamic testing . Age Ageing . 1992;21:195–201
  19. Griffiths DJ , McCracken PN , Harrison GM , Gormley EA . Cerebral aetiology of urinary urge incontinence in elderly people . Age Ageing . 1994;23:246–250
  20. Griffiths DJ , McCracken PN , Harrison GM , Gormley EA , Moore KN . Urge incontinence and impaired detrusor contractility in the elderly . Neurourol Urodyn . 2002;21:126–131
  21. Smith NKG , Morrant JD . Post-operative urinary retention in women: management by intermittent catheterization . Age Ageing . 1900;19:337–340
  22. Gilpin SA , Gilpin CJ , Dixon JS , Gosling JA , Kirby RS . The effect of age on the autonomic innervation of the urinary bladder . Br J Urol . 1986;58:378–381
  23. Homma Y , Imajo C , Takahashi S , Kawabe K , Aso Y . Urinary symptoms and urodynamics in a normal elderly population . Scand J Urol Nephrol . 1994;157(Suppl):27–30
  24. Trowbridge ER , Wei JT , Fenner DE , Ashton-Miller JA , DeLancey JOL . Effects of aging on lower urinary tract and pelvic floor function in nulliparous women . Obstet Gynecol . 2007;109:715–720
  25. Ng SC , Chen GD . Age effects on anorectal pressure in anal continent women with lower urinary tract dysfunction . Int Urogynecol J Pelvic Floor Dysfunct . 2007;18:295–300
  26. Fox JC , Fletcher JG , Zinsmeister AR , Seide B , Riederer SJ , Bharucha AE . Effect of aging on anorectal and pelvic floor functions in females . Dis Colon Rectum . 2006;49:1726–1735
  27. Aukee P , Penttinen J , Airaksinen O . The effect of aging on the electromyographic activity of pelvic floor muscles: a comparative study among stress incontinent patients and asymptomatic women . Maturitas . 2003;44:253–257
  28. Allen RE , Warrell DW . The role of pregnancy and childbirth in partial denervation of the pelvic floor . Neurourol Urodyn . 1992;6:183–184
  29. Bidmead J , Cardozo LD . Pelvic floor changes in the older woman . Br J Urol . 1998;82(Suppl 1):18–25
  30. Olsen AL , Ross M , Stansfield RB , Kreiter C . Pelvic floor nerve conduction studies: establishing clinically relevant normative data . Am J Obstet Gynecol . 2003;189:1114–1119
  31. Perucchini D , DeLancey JOL , Blaivas M . Evidence of major myopathic changes in the striated urethral sphincter muscle in the female . Neurourol Urodyn . 1997;15:394–395
  32. Perucchini D , DeLancey JOL , Ashton-Miller JA , Peschers U , Kataria T . Age effects on urethral striated muscle. I. Changes in number and diameter of striated muscle fibers in the ventral urethra . Am J Obstet Gynecol . 2002;186:351–355
  33. Perucchini D , DeLancey JOL , Ashton-Miller JA , Galecki A , Schaer GN . Age effects on urethral striated muscle. II. Anatomic location of muscle loss . Am J Obstet Gynecol . 2002;186:356–360
  34. Rud T , Andersson KE , Asmussen M , Hunting A , Ulmsten U . Factors maintaining the intraurethral pressure in women . Invest Urol . 1980;17:343–347
  35. Boreham MK , Wai CY , Miller RT , Schaffer JI , Word RA . Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse . Am J Obstet Gynecol . 2002;187:56–63
  36. Lin SY , Tee YT , Ng SC , Chang H , Lin PP , Chen GD . Changes in the extracellular matrix in the anterior vagina of women with or without prolapse . Int Urogynecol J Pelvic Floor Dysfunct . 2006;18:43–48
  37. Rociu E , Stoker J , Eijkemans MJ , Laméris JS . Normal anal sphincter anatomy and age- and sex-related variations at high-spatial-resolution endoanal MR imaging . Radiology . 2000;217:395–401

PII: S1028-4559(08)60006-6

doi:10.1016/S1028-4559(08)60006-6

Taiwanese Journal of Obstetrics and Gynecology
Volume 46, Issue 4 , Pages 374-378, December 2007