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September 17, 1973

Surgery in the Aged

Author Affiliations

University of Louisville Louisville, Ky

JAMA. 1973;225(12):1533. doi:10.1001/jama.1973.03220400059025

To the Editor.—  A letter from Reuben Tizes, MD (224:1761, 1973) reviews two case histories illustrating the plight of the aged undergoing extensive surgical procedures. I wholeheartedly agree with the principle he advocated about human factors requiring top consideration. It is a pity that countless elderly patients undergo surgical treatment without regard for physical, psychological, and social morbidity.Although the first case history illustrates his point, I wish to raise a question regarding his second case report. Suprapubic cystotomy is a minor surgical procedure and can be accomplished with the patient under local anesthesia.1 Prolonged urethral catheterization is fraught with more complications than suprapubic cystotomy, which is easier to manage. I think the decision of the urologist in this case was well founded, and the death of the patient three months later because of overwhelming sepsis cannot be blamed on suprapubic cystotomy. This patient was given palliative therapy, as