Abstract
An ageing population is mainly due to the reduction of births and the increase in life expectation. In Italy the percentage of people aged at least 65 years increased from 11.3% in 1971 to 15.3% in 1991. This increase mostly involved those aged 75 years and over. In the last four decades the average life span has extended by more than 11 years (from 65.5 to 76.9 years). The average life span in women is currently 80.2 years, almost 7 years longer than that of men. As age increases so does the incidence of various urological diseases requiring surgery, such as prostatic diseases (hyperplasia and carcinoma), urological tumours, urinary infections and incontinence. At the same time the probability of associated pathologies increases and consequently the risk of peri-operative complications, thus negatively influencing the prognosis. Surgery is only indicated in the elderly when it may increase life expectancy and/or improve the quality of life. A careful pre-operative evaluation of all the factors that may influence both life expectancy and quality of life is therefore indispensable, with particular reference to the actual disease and co-morbidity.
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