Abstract
There are no particularly important technical aspects to urethra reconstruction in the elderly compared to younger patients, but the surgical indications and especially the choice of technique must be carefully assessed. The risk factors which may influence the result of a urethroplasty in the elderly are: senescence of the urinary apparatus, ischemia, psychological instability. It is therefore vital not to jeopardise the urethral vascular fragility of elderly patients with an operation. The concept of vessel sparing is very important in urethroplasty in the elderly in order to preserve terminal vascularisation of the bulbar arteries as much as possible. A retrospective review of 98 patients (aged 12-82 years) who underwent urethroplasty showed that there is a greater risk of ischemia when free skin flaps exceeding 4 cm are used. Furthermore, urethroplasty divided into two sessions with temporary perineal urethrostomy can cause psychological disturbance in the elderly, often aggravating sub-latent clinical depression.
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