Urinary Incontinence and Pelvic Organ Prolapse in Women.

Area of Science:

• Urogynecology
• Pelvic Floor Disorders
• Women's Health

Background:

• Pelvic floor disorders are common, impacting quality of life, especially in pregnant, postpartum, postmenopausal, and elderly women.
• These conditions significantly affect patient well-being and require targeted management strategies.

Approach:

• This narrative review synthesizes findings from a selective literature search, prioritizing original articles and AWMF guidelines.
• Evidence levels (EL) were considered for evaluating treatment efficacy.

Key Points:

• Pelvic floor physiotherapy (EL 1), pessaries (EL 2), and local estrogen therapy can alleviate urinary incontinence and urogenital prolapse symptoms.
• Pharmacological options include anticholinergic/β-sympathomimetic drugs for overactive bladder and SSRIs for stress urinary incontinence (EL 1).
• Surgical standards include tension-free tape for incontinence (87.2% satisfaction at 17 years) and fascial reconstruction/mesh procedures for pelvic organ prolapse.

Conclusions:

• Physicians should proactively inquire about urogynecological symptoms and initiate conservative treatment first.
• Effective surgical techniques, with or without mesh, exist for urinary incontinence and pelvic organ prolapse.
• Preventive strategies for pelvic floor dysfunction should be implemented during pregnancy and postpartum periods.