[The surgical treatment of patients with bladder cancer in middle and old age]

Bladder tumors morphological and treatment efficacy data obtained on 246 relevant patients over 60 years of age support the benefit of surgery in combined treatment of bladder cancer in elderly patients in spite of difficulties caused by concomitant diseases and defective adaptation. High-grade poorly differentiated cancer of the bladder causing more frequent recurrences and metastases occur in patients over 60 two times less often than in younger patients. Transurethral electroresection of the bladder with removal of the tumor followed by intravesical immunoprophylaxis of the recurrences is thought a radical treatment for elderly patients with bladder cancer stage T1 and T2. At stage T3 cystectomy is preferable. Positioning of the ureters into the straight ileocecal angle provides the best results in urine derivation after cystectomy. Transurethral electroresection is optimal in the treatment of elderly patients with bladder cancer stage T1-T2 and prostatic adenoma. Indications to transurethral adenomectomy in the presence of bladder cancer must be maximally extended as adenomatous nodes provoke infravesical obstruction and speed up the recurrence of bladder cancer.