Your elderly urologic patients merit special assessment on several fronts. Many nonoperative urologic conditions, such as lower urinary tract symptoms, require treatment with medications that can affect cognition and/or interact with other daily medications [1]. Urinary afflictions such as frequency, urgency, and incontinence contribute to non-urologic morbidity because of requirement for movement and result in falls. The need to arise at night for voiding (nocturia) also leads to increased risk of falls in the darkened environment. Older patients’ needs differ because processes of aging make them different from those younger than 65 years. Why? Because the physiology of aging generates changes that cause the elderly to have less physiological strength in many organ systems. Perhaps one of the best illustrations of these changes is summarized in Fig. 1.3 [2]. Note that renal function decreases to 60% of normal by age 80, cardiac function by 30% and pulmonary function by 50–60%. Some geriatricians term this loss of reserve function in body systems as “homeostenosis” or lack of ability to respond adequately to external stresses, versus the usual beneficial response of “homeostasis”[3]. It is this inability to respond to stress that causes the increased risk levels that one tries to include in various co-morbidity classifications. And in addition to consideration of the usual disease conditions that one considers dangerous (hypertension, cardiovascular disease, pulmonary disease, diabetes, etc), there are a number of additional topics that pertain to the aged patient, termed “geriatric syndromes” (Table 1.3) [4].