Diagnosis and management of complex pelvic floor disorders in women

Objective: To review the evaluation and management of complex pelvic floor disorders in elderly women. Methods: Literature review and presentation of a clinical case. Results: Pelvic floor disorders are a common problem in elderly women. Pelvic organ prolapse and voiding complaints often coexist and several treatment options are available. A step-wise approach should be used in which management of the most bothersome symptoms occurs first. Conservative, medication, and surgical options should be discussed with each patient depending on treatment goals and health status. Some effects do overlap; however, treatment of one condition may not preclude treatment of other symptoms. Conclusion: In women with complex pelvic floor disorders, addressing the most bothersome symptom first will increase patient satisfaction. Patients should be counseled about the potential need for multiple treatments for optimal results.