Reconstructive urology and geriatrics: issues in older adults.

摘要

PURPOSE OF REVIEW: The elderly population is continuing to expand at record pace in the vast majority of countries worldwide. Many urologic conditions that necessitate reconstructive surgery occur in geriatric patients. To date, there has been a paucity of research on the effects of aging with regard to reconstructive procedures in elderly patients. This review examines factors that influence the feasibility and outcomes of reconstructive urologic surgery in older adults. RECENT FINDINGS: Age alone has generally not been identified as a significant predictive factor for outcomes in geriatric patients undergoing surgery. Comorbid diseases associated with reduction of physiologic reserve capacity and impairments in the level of independence for activities of daily living appear to have more predictive value. Recent research has focused on defining frailty as a condition that frequently occurs in older adults and may influence clinical outcomes. A variety of cellular and tissue changes associated with aging have also been studied. Inflammatory mediators may play an important role in this process. SUMMARY: Many urologic conditions that require reconstructive surgery occur in elderly patients. Careful planning may help to improve outcomes. However, there appear to be inherent changes associated with the physiology of normal aging that can significantly influence this process.