Search

Surgery of diseases of the pelvis minor and retroperitoneum such as inflammatory disease, malignant tumours, or trauma of pelvic organs need the close interdisciplinary collaboration of visceral surgeons, gynaecologists, and urologists. This collaboration begins in planning diagnostic and therapeutic procedures. It has to be clear who performs which operative step and when. Excellent long-term results in malignant disease show that the greater effort is worthwhile. The rate of postoperative morbidity after these multivisceral resections is high also in specialised centers, but mortality is below 5%. Because of the growing number of long-term survivors, preservation of quality of life becomes more and more important.

Important data on the occurrence of urological tumours are presented. In particular, the actual values and estimations have been compiled. In the Federal Republic of Germany 19135 patients died of genitourinary tumours in 1988:81.3% of these were male and 47.5% had prostatic carcinoma. Death occurred after the age of 69 years in 71.7%, and in 36.7% after the age of 79 years. It is estimated that 37,000 persons become ill with a urological neoplasm each year, and that approximately 120,000 cancer patients are presently alive in whom a primary tumour has been diagnosed in the urinary system within the last 5 years. This means for instance, a relation of about 80 patients in posttreatment care to one practising urologist and 9% of urology beds are occupied by patients receiving primary treatment for a tumour. The trend in mortality has been inhomogeneous in recent years, insofar as a 50% decline of testis tumour mortality has been observed, whereas an increase of between 15% and 20% has been observed in the mortality of renal cell carcinoma and an increase of approximately 10% in the mortality of bladder carcinoma in women. Altogether, the position with regard to epidemiological data on tumours is still unsatisfactory in the Federal Republic of Germany.