[Genital prolapse in elderly women (150 cases) (author's transl)]

A series of 150 operations, by the same surgeon, for genital prolapse in women over 60 years of age (range to 85 years), represented 36% of the total number of operations for prolapse performed. A total of 32 women had had previous prolapse operations, 24 developed prolapse after hysterectomy, and 11 had postoperative colpoceles. This means that 45% had iatrogenic lesions, term in fashion at the present time but which strongly emphasizes the role played by insufficiently defined operative indications, and operations conducted without sufficient rigour. The most frequent lesions, were firstly cystoceles, then external prolapses, followed by hysteroceles. Urinary incontinence was evident in 15%, and potential in at least 10% of continent women. The lower approach was employed for the operation, either obturating or conservative, in most cases. When the upper approach was used, this was mainly for pathogenic purposes, and adapted to the lesion. Overall results were excellent, and only two irreversible accidents occurred. Recurrences were mainly in the form of cystoceles, micturition disorders, or sometimes rectocele sequelae. Increased life-span and improved operative treatment should make the surgery of prolapse in elderly women even more effective.