[Prolapse and urinary incontinence in women : place of the general practitioner]

The ageing of the population, having access to good quality of care, will result in an increase in the prevalence of pelvic floor diseases. Those persons, often in good general health, may experience difficulties in accepting functional pathologies, associated with loss in quality of life. One out of 2 women will have a pelvic floor problem and 1 out of 9 will have a surgical perineal procedure before the age of 80 years. The unitary character of the pelvic floor, a complex functional anatomic region, is often forgotten, essentially because the patients complain about one main pathology like urinary incontinence, genital prolapse, constipation and sexual disorders or chronic pain and will consult one specific specialist. Our role as health care professionals is to be aware of those associated pathologies and to obtain an optimal quality of care. The actual evolution towards specific clinical pathways with the integration of office provided care outside the hospital, needs to become the new standard of care. We try to give an overview of the different preventive, diagnostic and therapeutic options, available in a general practitioner's office. Taking care of the pelvic floor needs to be done in a global and pluridisciplinar setting. Referring towards specialised centres as well as the integration of the general practitioner, especially for the more complex cases, is essential.