We have assessed the influence of age on the mode of presentation and perioperative mortality in 1033 patients with colorectal cancer. There were 522 patients (51 per cent) over 70 years (group I) and 511 patients (49 per cent) under 70 (group II). In group I, 301 patients (58 per cent) were admitted as emergencies compared with only 222 (43 per cent) in group II (P less than 0.001). Perioperative mortality was especially high in the elderly emergencies, 38 per cent, compared with 18 per cent for elective operations. Of the patients presenting as emergencies in either age group 66 per cent had localized "potentially curable' disease. The incidence of colorectal cancer is highest in the elderly. A larger number of these elderly patients present as emergencies and die from the consequences of complications of localized disease. Earlier diagnosis by pre-symptomatic screening is therefore especially desirable in these old patients.

Holmium laser excision of intravesical polypropylene tape or suture is a minimally invasive solution to the problem of intravesical perforation or erosion following anti-incontinence procedures.

Objective-To determine whether intrauterine growth retardation associated with normal umbilical artery blood flow is a benign condition. Design-A prospective comparative study of growth retarded fetuses with normal and abnormal umbilical artery blood flow. Setting-The fetal assessment clinic of a large maternity hospital in Ireland. Patients-179 Women with singleton pregnancies in which the fetal abdominal circumference, measured by ultrasonography, was below the fifth centile for gestation. Main outcome measures-Perinatal deaths, fetal distress requiring caesarean section, preterm delivery, cerebral irritation. Results-Of 124 fetuses with normal flow, all physically normal fetuses survived but one baby had cerebral irritation; there were six preterm deliveries and four caesarean sections for fetal distress. Among 55 women with physically normal fetuses with abnormal flow there were two midtrimester abortions, three perinatal deaths, and one case of cerebral irritation; there were 23 preterm deliveries and six caesarean sections for fetal distress in labour. Conclusions-Intrauterine growth retardation associated with normal umbilical blood flow is a different entity from that associated with abnormal flow, normal flow being largely benign and abnormal flow carrying a serious risk of adverse outcome.