ABSTRACT
Patients requiring anesthesia for genitourinary procedures are often of advanced age. The choice of anesthetic technique varies with the patient and the type of procedure. For most flexible cystoscopies, topical anesthesia with lidocaine is used successfully particularly in women because of the short urethra. Benign prostatic hypertrophy is a disease seen in the elderly male population, and may require surgical removal of the prostate gland. Surgical intervention becomes necessary when obstruction of urinary outflow through the prostatic urethra becomes symptomatic. The incidence of postoperative complications, namely myocardial infarction, pulmonary embolism, cerebrovascular accidents, transient ischemia attacks, renal failure, hepatic insufficiency, and the need for prolonged ventilation is similar when comparing patients receiving regional anesthesia with those receiving general anesthesia. Radical nephrectomy is most commonly performed for adenocarcinoma of the kidney. This disease has a peak incidence in the fifth and sixth decades of life, with a male to female ratio of 2:1.
