Taneja’s Complications of Urologic Surgery Diagnosis, Prevention, and Management FIFTH EDITION
Taneja’s Complications of Urologic Surgery Diagnosis, Prevention, and Management FIFTH EDITION Every urologist would prefer that any patient who has a consultation for a urologic disease would be solely afflicted with the disease for which he or she seeks medical attention, that every surgical patient would be healthy enough to tolerate the proposed surgical intervention to treat the condition, and that complications would occur with only miniscule probability. Unfortunately, this situation is far removed from reality and certainly is becoming less common
in current clinical practice in which medical histories, phys- ical examinations, preoperative laboratory examinations, and imaging scans are likely to reveal coexisting medical
problems in the urologic patient.
In the present era, with life expectancy ever increasing, the prevalence of comorbid conditions such as obesity, heart disease, and diabetes, which affect urologic diseases and their clinical outcome following management, has congruently reached alarming proportions in the general population. Whether driven by improved medical science, rapid technologic advancement, or an effect of natural selection, men and women are living longer.
The medical community recognizes special considerations for elderly
patients, and most of these considerations are brought about by medical conditions that are diagnosed in later life and progress with advancing age. In urologic disease entities such as erectile dysfunction in men, pelvic floor disorders in women, and urologic malignant diseases such as prostate and bladder cancer, the predisposition and clinical
effects related to advanced age have direct biologic implications for the urologic condition. Moreover, because most of these disease entities are diagnosed in the more mature stages of life, the probability of preexisting medical conditions in these patients at the time of consultation is high.
Notwithstanding the effect of age on comorbid medical .conditions in the urologic patient, the past decades have
also seen a dramatic rise in the prevalence of disease entities
closely linked to harmful lifestyle choices such as smoking and alcohol consumption, unhealthy diets, lack of physical activity, and intravenous drug abuse.
These lifestyle choices adversely affect patients of all ages who may seek urologic consultation and who may present with detrimental comorbidities such as childhood obesity, juvenile diabetes, chronic obstructive pulmonary disease, liver disease, and human
immunodeficiency virus/acquired immunodeficiency syn-