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What Elderly Women Should Know About Urogenital Health

Scott A. Farrell, BA, BEd, MD, FRCSC, Iwk Health Centre, Halifax, NS.

Introduction
Adult women who enjoy urogenital health are usually sublimely unaware of their pelvic organs. It is not until urogenital organ dysfunction occurs that attention is focused upon factors that are essential to the maintenance of a healthy urogenital tract. Maintenance of urogenital health is largely dependent upon healthy lifestyle habits and, to a lesser extent, a woman's hormonal milieu. This article will briefly discuss the following relevant topics: normal anatomy and function, the effect of lifestyle and hormones on normal functioning of the urogenital organs, and common problems encountered with aging.

Normal Anatomy and Function of the Urogenital Tract
The urogenital tract is composed of three organ groups which lie in close proximity within the pelvic cavity: the bladder and urethra; the genital organs (uterus, fallopian tubes, ovaries, vagina and vulva); and the rectum and anal canal. These organs share a common embryologic origin and all possess estrogen receptors.1,2 They rest upon a common support structure--the pelvic diaphragm or levator muscles3--which not only invests each organ with supportive fibres, but also contributes to the mechanisms that maintain urinary and anal continence and close the introitus of the vagina. The urethral and anal continence mechanisms are dependent upon the normal functioning of both smooth and striated muscle sphincters.