CUA 2018: Urologic Conditions in Nonagenarians

Halifax, Nova Scotia ( The Canadian populations is rapidly aging with centenarians comprising the fast-growing age group nationally. Sparse urological research exists on nonagenarians or centenarians. A study from United Kingdom of nonagenarian urology inpatients found the most common diagnoses to be hematuria and lower urinary tract symptoms (LUTS) and these patients had significantly longer and more complicated hospital stays than their younger counterparts (Pridgeon et al, 2016). 

Tarek Lawen, MD, presented a study where authors aimed to perform a descriptive study to assess the most common urological referrals and diagnoses in nonagenarian patients. They also sought to determine which investigations and treatment modalities were used by urologists and how frequently management was altered due to patient age. 

Authors performed a retrospective chart review of all referrals in patients aged 90 and above at a single academic institution. This included referrals to 11 urologists from 2007 to 2017. Data was extracted from multiple electronic health records. 

The most common reason for referral was hematuria in both males and females. Cystoscopy was commonly performed in nonagenarians. Bladder tumor was the most frequent diagnosis made in both genders. Despite this, only 66% of bladder tumors underwent transurethral resection. In 18% of cases, treatment decisions were altered because of the patient's advanced age. 

Dr. Lawen concluded that nonagenarians referred to urology often present with common urinary symptoms. Consistent with previous literature, BPH, bladder tumors and UTIs are common diagnoses in this population. Despite common diagnoses, at time management plans vary to very advanced age. Indeed, this study and data is important for multiple reasons. First and foremost is that the mean age of overall population in United States and Worldwide is increasing due to improvement of lifestyle and quality of life. With advanced age and more older patients, urologists more frequently will be seeing elderly patients including nonagenarians.

Presented by Tarek Lawen, MD
Co-Authors: Anjali Lobo, Karthik Tennankore, Ashley Cox 

Written by Zhamshid Okhunov, MD, Twitter: @OkhunovZham, Department of Urology, University of California-Irvine at the 73rd Canadian Urological Association Annual Meeting - June 23 - 26, 2018 - Halifax, Nova Scotia