Perioperative Assessment in the Older Woman Undergoing Pelvic Floor Surgery

Purpose of ReviewThis review aims to summarize the data currently available on perioperative issues pertinent to the aging adult to help provide a resource for surgical caregivers.Recent FindingsOlder adults can safely undergo pelvic surgery and expect improvements in their quality of life. Preoperative evaluation may need to consider an individual's risk based on their medical comorbidities and baseline functional status, rather than age alone. Frailty has been identified as an important factor when determining a patient's risk of complications from pelvic floor surgery and their expected course of recovery.Access to improved healthcare has led to an aging population that presents unique challenges to medical providers. These challenges impact surgical outcomes and are particularly important for specialties more likely to care for older patients, such as Urogynecology and Reconstructive Pelvic Surgery. Normal age-related physiologic changes, polypharmacy, and a decline in functional status all may inhibit optimal postoperative outcomes. Alterations in organ systems may make aging adults more susceptible to complications from both medications and surgery. The older patient is also at risk for cognitive impairment and frailty concerns, which have been shown to impact surgical recovery. Providers may need to familiarize themselves with these conditions and the general changes seen in the aging adult to help improve patient outcomes. Validated questionnaires and tools are available for time-efficient screening of conditions that may require further optimization prior to surgery.