Der Urologe, Ausgabe A

, Volume 43, Issue 8, pp 916–921 | Cite as

Urologische Erkrankungen im Alter

Leitthema
  • 65 Downloads

Zusammenfassung

Das Auftreten urologischer Erkrankungen im Alter ist ein zunehmendes, klinisches Problem, da die Lebenserwartung steigt und mit zunehmenden Alter die Inzidenz urologischer Erkrankungen zunimmt. Es fehlen aber ausreichende Daten zur Beurteilung verschiedener Therapieverfahren bezogen auf Patienten über 70 Jahre [42]. Das Alter an sich stellt keinen eigenen Vorhersagewert für ein Behandlungsergebnis dar. Viel wichtiger erscheint es, ältere Patienten hinsichtlich ihres funktionellen Status, ihrer Komorbidität, ihrer sozioökonomischen Verhältnisse, ihrer kognitiven und emotinalen Fähigkeiten sowie ihres Ernährungszustandes einzuschätzen.

Schlüsselwörter

Vorhersagewert Behandlungsergebnis Geriatrische Urologie Urologische Erkrankungen Hohes Alter 

Urological illnesses in the elderly

Abstract

Urological illnesses in the elderly are a growing clinical problem because as life expectancy increases so does the prevalence of such illnesses. However, sufficient data for judging the various possible therapies are lacking for patients over the age of 70. Age itself does not have enough predictive value for the determination of the best treatment. It seems more important to estimate the functional and socio-economic status, comorbidity, and the cognitive and emotional abilities of elderly patients as well as their nutritional intake.

Keywords

Predictive value Treatment results Geriatric urology Urological illnesses Aged patients 
This is a preview of subscription content, log in to check access.

Notes

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

Literatur

  1. 1.
    Gomolin ICH, Mc Cue JD (2000) Urinary tract inferction in the elderly patient. Infections in Urology 13 (Suppl): 7Google Scholar
  2. 2.
    Baldassare JS, Kaye D (1991) Special problems of urinary tract infection in the elderly. Med Clin North Am 75: 375PubMedGoogle Scholar
  3. 3.
    Nicolle LE (1999) Urinary infections in the elderly: symptomatic or asymptomatic? Int J Antimicrobiol Agents 11: 265CrossRefGoogle Scholar
  4. 4.
    Bonadio M, Meini M, Spitalery P, Gigli C (2001) Current microbiological and clinical aspects of urinary tract infections. Eur Urol 40: 439CrossRefPubMedGoogle Scholar
  5. 5.
    Abrutyn E, MosseyJ, Berlin JA, Boscia J, Levision M, Pitsakis P, Kaye D (1994) Does asymptomatic bacteriuria predict mortality and does antimicrobial treatment reduce mortality in elderly ambulatory women? Ann Intern Med 120: 827PubMedGoogle Scholar
  6. 6.
    Ronald A, Ludwig E (2000) Urincary tract infections in adults with diabetes. Int J Antimicr Agents 17: 287CrossRefGoogle Scholar
  7. 7.
    Geerlings SE, Hoepelman Al (1999) Immunodysfunction in ptients with diabetes mellitus (DM). FEMS Immuno Med. Microbiol 26: 259CrossRefGoogle Scholar
  8. 8.
    Zimakoff J, Pontoppidan B, Lars SO, Stickler DJ (1993) Management of urinary bladder-function in Danish hospitals, nursing homes and home care. J Hosp Infect 24: 183PubMedGoogle Scholar
  9. 9.
    Liedl B (1999) Katheterassoziierte Harnwegsinfektionen. In: Hofstetter A (Hrsg) Urogenitale Infektionen. Springer, Berlin Heidelberg New York Tokio, S 241–263Google Scholar
  10. 10.
    Schmucker DL (2001) Liver function and phase I drug metabolism in the elderly: a paradox. Drugs Aging 18: 837PubMedGoogle Scholar
  11. 11.
    Naber KG, Fünfstück R, Hofstetter A, Brühl P, Hoyme U (2000) Empfehlungen zur antimikrobiellen Therapie von Infektionen der Nieren und des Urogenitaltraktes bei Erwachsenen. Chemother J 6: 193Google Scholar
  12. 12.
    Vahlensieck W Jr (1999) Prophylaxemaßnahmen bei rezidivierenden Harnwegsfektionen. In: Hofstetter A (Hrsg) Urogenitale Infektionen. Springer, Berlin Heidelberg New York Tokio, pp 215–239Google Scholar
  13. 13.
    Mack DJ, Smart L, Girdwood A, Scott PJW, Fulton JD, Erwin L (1993) Infeciton prophylaxis with lactulose. Age Ageing 22 (Suppl 2): 8Google Scholar
  14. 14.
    Raz R, Stamm WE (1993) A controlled trial of intravaginal estriol in post-menopausl women with recurrent urinary tract infections. N Engl. Med J 329: 753CrossRefGoogle Scholar
  15. 15.
    Hampel C, Wienhold D, Benken N, Eggersmann C, Thüroff JW (1997) Definition of overactive bladder and epidemiology of urinary incontinence. Urology 50 (Suppl 6A): 4–14CrossRefPubMedGoogle Scholar
  16. 16.
    Diokno AC, Brock BM, Brown MB, Herog AR (1996) Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol 136: 1022–1025Google Scholar
  17. 17.
    Ouslander JG (1992) Geriatric urinary incontinence. Dis Mon 38: 65–149PubMedGoogle Scholar
  18. 18.
    Elbadawi A, Hailemariam S, Yalla SV, Resnick NM (1997) Structural basis of geriatric voiding dysfunction. VII. Prospektive ultrastructural/urodynamic evaluation of its natural evolution. J Urol 157: 1814–1822CrossRefPubMedGoogle Scholar
  19. 19.
    Elbadawi A, Diokno AC, Millard RJ (1998) The aging bladder: Morphology and urodynamics. World J Urol 16 (Suppl 1): 10–34Google Scholar
  20. 20.
    Lin AT, Yang CH, Chand LS (1997) Impact of aging on rat urinary bladder fatigue. J Urol 157: 1990–1994CrossRefPubMedGoogle Scholar
  21. 21.
    Melchior HJ, de Geeter P (2000) Miktionsstörungen und Harninkontinenz. Diagnostik und Therapie in der (haus)ärztlichen Praxis. pmi, FrankfurtGoogle Scholar
  22. 22.
    Anderson JB, Roehrborn CG, Schalken JA, Emberton M (2001) The progression of benign prostatic hyperplasia: examining the evidence and determing the risk. Eur Urol 39: 390–399CrossRefPubMedGoogle Scholar
  23. 23.
    Jacobsen SJ, Girman CJ, Lieber MM (2001) Natural history of benign prostatic hyperplasia. Urology 58 (Suppl 1) 5–16Google Scholar
  24. 24.
    Roehrborn CG, Malice M, Cook TJ, Girman CJ (2001) Clinical predictors of spontaneous acute urinary retention in men with LUTS and clinical BPH: a comprehensive analysis of the pooled placebo groups of several large clinical trials. Urology 58: 210–216CrossRefPubMedGoogle Scholar
  25. 25.
    Arrighi HM, MetterEJ, Guess HA, Fozzard JL (1991) Natural history of benign prostatic hyperplasia and risk of prostatectomy. The Baltimore Longitudinal Study of Aging. Urology 38 (Suppl 1): 4–8PubMedGoogle Scholar
  26. 26.
    Berges RR, Pientka L, Hofner K, Senge T, Jonas U (2001) Male lower urnary tract symptoms and related health care seeking in Germany. Eur Urol 39: 682–687CrossRefPubMedGoogle Scholar
  27. 27.
    Blanker MH, Bohnen AM, Groeneveld FPMJ, Bernsen RMD, Prins A, Bosch JLHR (2000) Normal voiding patterns and determinants of increased diurnal and nocturnal voiding frequency in elderly men. J Urol 164: 1201–1205CrossRefPubMedGoogle Scholar
  28. 28.
    Jacobsen SJ, Jacobson DJ, Gierman CJ, Roberts RO, Rhodes T, Guess HA, Lieber MM (1999) Treatment for benign prostatic hyperplasia among community dwelling men: the Olmsted County study of urinary symptoms and health status. J Urol 162: 1301–1306CrossRefPubMedGoogle Scholar
  29. 29.
    De Rijke JM, Schouten LJ, Hillen HFP et al. Cancer in the very elderly dutch population. Cancer 89: 1121–1133Google Scholar
  30. 30.
    Becker (2002) Epidemiologie. In: Höffken K, Kolb G, Wedding U (Hrsg) Geriatrische Onkologie. Springer, Berlin Heidelberg New York Tokio, S 1–28Google Scholar
  31. 31.
    Cohen HJ (1994) Biology of aging as related to cancer. Cancer 74: 2092–2100PubMedGoogle Scholar
  32. 32.
    Hart RW, Turturro A (1992) Overview of cancer an aging: a mechanistic perspective. Exp Gerontol 27: 441–445CrossRefPubMedGoogle Scholar
  33. 33.
    Lance RG, Grossmann HB (2001) Chemotherapy in the elderly. Sem Urol Oncol 19: 51–55Google Scholar
  34. 34.
    Figueroa Ajm, Stein JP, Dickinson M et al. (1998) Radical cystectomy for elderly patients with bladder carcinoma—an updated experience in 404 patients. Cancer 83: 141–147CrossRefPubMedGoogle Scholar
  35. 35.
    Middleton AW (1987) Radical prostatectomy for carcinoma in men more than 69 years old. Cancer Control 7: 548–556Google Scholar
  36. 36.
    Dillioglugil O, Leibman BD, Leibman NS et al. (1997) Risk factors for complications and morbidity after radical prostatectomy. J Urol 157: 1760–1767CrossRefPubMedGoogle Scholar
  37. 37.
    Alberson PC, Fryback DG, Storer BE, Kolon TF, Fine J (1996) The impact of co-morbidity on life expectancy among men with localized prostate cancer. J Urol 156: 127–132CrossRefPubMedGoogle Scholar
  38. 38.
    Severson RK, Montie JE, Porter AT, Demers RY, Recent trends in incidence and treatment of prostate cancer among elderly men. J Natl Cancer Inst 87: 532–534Google Scholar
  39. 39.
    Kanamaru H, Arai Y, Akino H et al. (1999) Long-term treatment results of elderly patients with prostate cancer in Japan: an analysis of prognostic factors. Jpn J Clin Oncol 29: 151–155CrossRefPubMedGoogle Scholar
  40. 40.
    Lichtmann SM, Villani G (2000) Chemotherapy in the elderly: Pharmacologic considerations. Cancer Control 7: 548–556PubMedGoogle Scholar
  41. 41.
    Balducci L, Hardy CL, Lyman GH (2000) Hematopoetic reserve in the older cancer patient: clinical and economic considerations. Cancer Control 7: 539–547PubMedGoogle Scholar
  42. 42.
    Drach GW, Griebling TL (2003) Geriatric Urology. J Am Soc Geriatr Med 51: S355–S358CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Geriatrische Urologie—Urologische KlinikCaritaskrankenhausBad Mergentheim
  2. 2.Urologische KlinikCaritaskrankenhausBad Mergentheim

Personalised recommendations