Special Conditions: Management of Concomitant Urological Pathology and the Comorbid Patient

Life expectancy continues to increase and as a result more frail, elderly and co-morbid patents are undergoing surgery (Brodak et al. Clin Interv Aging. 10:379–85, 2015). This is acutely seen in the management of men with prostatic disease. Urologists are increasingly encountering the older man with larger (>100 cc) prostates and concurrent and multiple co-morbidities. Urological diseases such as bladder and renal stones, bladder tumours and benign prostatic enlargement often necessitate concurrent or staged operative management. The grossly enlarged prostate can hinder or obstruct progress in the initial operation due to mass effect and bleeding. Identification and planning is key for successful outcomes in these men. Ensuring that the right equipment is available is a critical step before the cystoscopic inspection of the lower urinary tract has even started.