ABSTRACT
INTRODUCTION The range of urological surgery is impressive, covering reconstructive surgery of congenital defects of the urinary tract, malignancy, incontinence, stones, spinal cord injury and impotence. It covers all ranges of patients from the newborn to the adult and often elderly patient with numerous medical problems. Adults only are considered in this chapter. A close working relationship between surgeon and anaesthetist is crucial to the success of the operation phase for any urological patient. The anaesthetist must ensure patient safety and optimization of the medical conditions influencing outcome. In the unfit patient, this may require deferment or further investigation, as well as planning elective high-dependency unit (HDU) or intensive-care unit (ICU) admission. Many patients today are screened in the preadmission outpatient clinic, but it remains a common cause for cancellation in the day-case clinic that a patient arrives for day-case surgery with a recognized but untreated condition such as hypertension. It is also important that conditions that have serious anaesthetic implications, such as sickle-cell disease and malignant hyperpyrexia, or a family history of medical or anaesthetic complications, are referred early and appropriately to the anaesthetist.
