Invited Commentary

Abstract

All surgeons in the United States (and indeed other countries) will encounter more elderly patients during future years of practice. Thus, texts like this one serve a very important need by providing references that are valuable in management of such patients. And, for those disciplines that deal with the genitourinary system, the need is greater. Why? Because the average urologist now encounters about 50% of all office patients in the over-65 age (Medicare) category. And, because of the population growth in the older age decades described previously in this text, the urologist will see even more and more elderly patients in his or her office. For example, prostate cancer is now the eighth most common diagnosis amongst Medicare patients, and most of these patients receive their ongoing care from urologists [1]. Added to these activities is the malady of female urinary incontinence which continues to be a major life problem for older women, diagnosed and treated by urologists and gynecologists alike. Independent health surveys of these older women estimate that 9.2–27.6% has some degree of incontinence [2], and most do not mention this to their physicians. Some men also develop incontinence, often related to treatment for that increasing disease condition, prostate cancer. Improvement or cure of incontinence results in significant increases in quality-of-life scores for elderly patients.