title: [Urinary diversion in elderly patients].
abstract: BACKGROUND
  Bladder cancer represents one of the ten most prevalent cancers worldwide. More than 400,000 people worldwide are newly diagnosed every year. Within 2 years after diagnosis, 80% of patients with muscle invasive bladder cancer without treatment die.
  
  
  METHODS
  The aggressive local surgical approach with a cystectomy is the therapy of choice. The median age of patients with de novo bladder cancer is 70 years. Thus bladder cancer is a cancer of the elderly. For demographical reasons, the number of eldery patients undergoing radical cystectomy will rise in the next few years. The type of urinary diversion is a major factor influencing perioperative morbidity and quality of life in these patients. Incontinent urinary diversions are preferentially used in daily practice.
  
  
  CONCLUSIONS
  There are only a few contraindications for orthotopic neobladder; however, age alone is not a contraindication. Patient selection and a nerve sparing approach are crucial in men and women to achieve excellent functional results with orthotopic neobladder in elderly patients.
authors.affiliation: Urologische Universitätsklinik, Inselspital Bern, Anna Seiler-Haus, CH-3010, Bern, Schweiz. martin.spahn@insel.ch.
authors.forename: M
authors.initials: M
authors.lastname: Spahn
authors.affiliation: Urologische Universitätsklinik, Inselspital Bern, Anna Seiler-Haus, CH-3010, Bern, Schweiz.
authors.forename: S
authors.initials: S
authors.lastname: Boxler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D018579:Patient Selection; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
keywords: Cystectomy; Ileocecal pouch; Neobladder, orthotopic; Pouch, catheterizable; Urinary bladder neoplasms