• Gynecologic examination of 680 women between the ages of 41 and 111 led to a classification of pelves into a fibrotic (556 cases) and an atrophic (124) type. All instances of carcinoma, prolapse, and advanced cystocele, rectocele, and enterocele occurred in the atrophic type. No malignancies were ever encountered in the fibrotic type.
Although 90 of these institutionalized women had complete urinary incontinence and 63 complete loss of bowel control, gynecologic symptoms were present in only 69 cases, and many patients who had no complaints were found to have striking abnormalities. Among the many unanticipated results were the finding of complete procidentia among nulliparas and of a normal vulva in seven out of nine women over the age of 95. An estrogen effect was seen in the stained vaginal smears from four women over the age of 81 in the absence of estrogen therapy.
The study disclosed many opportunities for improving the health and comfort of these patients and emphasized the need of the elderly woman for good nursing care, including careful pelvic hygiene.
Folsome CE, Napp EE, Tanz A. PELVIC FINDINGS IN THE ELDERLY INSTITUTIONALIZED FEMALE PATIENTA GYNECIC SURVEY OF SIX HUNDRED EIGHTY PATIENTS. JAMA. 1956;161(15):1447–1454. doi:10.1001/jama.1956.02970150015004
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