Chapter 54
- Anesthesia and the Renal and Genitourinary Systems
- Vinod Malhotra
- Vijayendra Sudheendra
- Sudhir Diwan
Patients requiring anesthesia for renal and genitourinary surgery
are frequently at the extremes of age. Concomitant cardiovascular and respiratory
disease is common in the elderly, in addition to the physiologic changes of aging.
A medical history, physical examination, and appropriate laboratory tests are necessary
to evaluate concomitant disease. In pediatric urologic patients, upper respiratory
infections are not uncommon. A careful history should be obtained to exclude other
congenital lesions if the urologic procedure is planned for congenital urologic anomalies,
such as exstrophy of the bladder or Wilms' tumor.[1]
Urologic procedures are performed mostly on the kidneys, adrenals,
ureters, urinary bladder, prostate, urethra, penis, scrotum, testis, and spermatic
cord. Because their sensory nerve supply is primarily thoracolumbar and sacral outflow
( Table 54-1
), these structures
are well adapted for regional anesthesia.
