Review Article: Gynecological Disorders in Geriatric Emergency Medicine

Abstract

Emergency physicians must be competent in caring for elderly women because they constitute the fastest growing segment of the population in the United States. Familiarity with acute geriatric gynecologic issues is crucial to providing satisfactory health care for these patients with complaints relating to incontinence, pelvic floor dysfunction, and other gynecologic conditions. Vigilant suspicion for malignancy should be maintained in facilities that service patients without primary health care or insurance. This article provides a systematic approach to emergency department management of common geriatric gynecological conditions. Anatomical and physiological changes are discussed, as well as the geriatric pelvic examination, malignancy, urinary tract infection, incontinence, pelvic organ prolapse, and vulvovaginitis.

Gynaecological Prolapse Surgery in Very Old Female Patients

“…The objectives in these cases are to improve the quality of life and to maintain social independence. The decision to subject a woman aged 80 or more years to prolapse surgery should be made in dependence on the level of suffering, the lack of alternatives, e.g., pessary therapy in cases with eroded or ulcerated vaginal skin [4], on the general condition and the presence of co-morbidities. The choice or operative method [5] with its impact on the duration of surgery should be adapted individually to the complex situation.…”

Bir Aile Hekimliği Bölgesinde Yaşayan Geriatrik Kadınların Jinekolojik Şikâyetleri ve Çözüm Arayışlarının Belirlenmesi

“…Daha seyrek olarak bakteriyel vajinozis, gonore gibi diğer vajinal enfeksiyonlar ile de karşılaşılabilir (Lewiss, Saul and Teng 2009). Trichomonas vajinit ve vulvit bu yaş grubunda oldukça nadirdir (Moroney and Zahn 2007).…”

“…Yaşlı kadınlarda Ecoli başta olmak üzere Klebsiella, Proteus gibi birçok etken nedeni ile idrar yolu enfesiyonu sıklıkla görülür. Bu tabloda immün sistem yetersizliği, beslenme bozukluğu, inkontinans, staza bağlı mesanenin tam boşaltılamaması gibi birçok neden etkilidir (Lewiss, Saul and Teng 2009). Ayrıca geriatrik yaş grubunda idrar yolu enfeksiyonu yönetimi; tanı belirsizliği, çoklu ilaç kaygıları, dirençli mikroorganizmalar ve tedavinin etkinliğini azaltan konak faktörleri nedeniyle zor ve karmaşık olmaktadır (Miller and Baraldi 2012 …”