Search

It is certainly true that an increase in the average life span has caused a greater percentage of elderly people to visit urological departments. From April 1989 to December 1996, 52 patients over 75 years underwent radical cystectomy and urinary diversion. The numerical analysis of our experience has highlighted the fact that in operated patients the incidence and mortality caused by cardiovascular diseases were no higher than those found in other people of the same age.

The clinical and histopathological findings in a case of primary malignant lymphoma of the urinary bladder and morphologic and immunophenotypic characterization are reported with a review of the literature.

Surgical trauma can sometimes seriously impair the body feed-back mechanism because of consequent stress and fasting. In these cases alimentary requirements are satisfactorily fulfilled by total parenteral nutrition. As a result of our experience we think that a total parenteral nutrition program should be reserved for selected patients.

The objective of our study is to evaluate if patients aged over 75 years show, once operated, a different state compared to younger patients. We have taken two groups of patients from our case histories: patients who underwent major surgery (with the exception of operations which are usually not performed on those over 75 years old) and patients who underwent minor surgery. This second group is made up of patients who underwent treatment for prostate hypertrophy either surgically or endoscopically. In these groups we have tried to see any differences concerning the percentage of operated patients, mortality, early and late complications and the average length of stay in hospital.

It is certainly true that increase of the average life span has caused a greater percentage of elderly people to visit urological departments. From April 1989 to December 1991, patients over 75 years under our observation were 10.8% of all operated patients. Only 5% of patients over 75 who needed to be operated, weren't actually operated. The numerical analysis of our experience has highlighted the fact that in patients who underwent an operation, the incidence and mortality caused by cardiovascular diseases weren't any higher than those found in other people of the same age. We are also convinced that prejudices about age limits should not prevent the elderly afflicted with a benign or malignant urological pathology from undergoing an operation.

Two groups of patients have been chosen from our operating case histories (April '89 - December '91). They were subjected respectively to major and minor surgery. In the first group radical surgery of the kidney and of the bladder was considered while in the second group we examined the surgical and endoscopic treatment of benign prostatic hypertrophy. The selected patients were subsequently subdivided according to age (under and above 75 years old) and according to the kind of operation.

The request for surgery for the elderly is increasing from year to year. In fact a longer average age has brought about the necessity to study the physiology of the ageing process. Increasing knowledge has led to a deeper understanding of geriatric physiopathology, so that 65 years is no longer considered the age limit to define a person “elderly”. On the other hand the elderly no longer accept being marginalized due to their infermity. On the contrary they ask for the same therapeutical measures which are used for younger people.