LOWER URINARY TRACT SYMPTOMS AND VOIDING DYSFUNCTION (J SANDHU, SECTION EDITOR) A Systematic Review of Postoperative Delirium in the Urologic Patient Michelina D. Stoddard 1 & Ahra Cho 1 & Stephanie A. Chen 1 & Claire Dunphy 2 & Drew N. Wright 3 & Bilal Chughtai 1 Accepted: 15 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Purpose of Review Postoperative delirium (POD) is a common phenomenon among general surgery patients, but it is not well described in urologic surgical patients. We sought to define the incidence and predictive risk factors for POD in patients undergoing urologic surgery. Recent Findings Eighteen articles were included for review. The pooled incidence rate of postoperative delirium after urologic surgery was 1.69% (0.69–46.97%). Longer intraoperative time, male sex, unmarried status, and age were shown to be risk factors for POD. Summary POD is common after many urologic surgeries and leads to worse postoperative outcomes and higher healthcare utilization. Future studies are needed to better assess for and prevent POD. Keywords Postoperative delirium . Urologic surgery outcomes . Complications of urologic surgery . Post-operative delirium risk factors Introduction Postoperative delirium (POD) is characterized by changes in mental status, including pronounced impairments in attention, awareness, and cognition with acute onset and fluctuating course [1]. Typically occurring within 1 week of a surgical procedure [2], POD is associated with poor outcomes, including postsurgi- cal complications [ 3], increased mortality [4, 5], and long-term mild cognitive impairment [6]. POD is also associated with in- creased length of hospitalization [7] and increased healthcare costs [7–9]. Reported incidence of POD ranges from 3 to 65% [3–5, 7, 9, 10]. Although the incidence of POD has been well characterized in select patient populations (e.g., those who un- dergo cardiac surgery), few studies have been conducted on POD in patients undergoing urologic surgery. POD is of particular interest in the urologic setting because a high number of patients undergoing urologic surgery are older adults [11], and prior stud- ies have identified age as a risk factor for POD [3–10]. We performed a systematic review of the literature on POD after urologic surgery, with particular focus on the incidence and risk factors of POD to better understand the relationship between POD and urologic surgery. We sought to determine which risk factors were associated with increased risk of POD in patients who undergo uro- logic surgery. Materials and Methods We performed a systematic literature search according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Fig. 1)[12]. The review was conducted as described below. This article is part of the Topical Collection on Lower Urinary Tract Symptoms and Voiding Dysfunction Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s11934-020- 01010-0. * Bilal Chughtai bic9008@med.cornell.edu 1 Department of Urology, Department of Obstetrics and Gynecology, Weill Cornell Medical College/New York Presbyterian, 425 East 61st Street, 12th Floor, New York, NY 10065, USA 2 Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA 3 Samuel J. Wood Library and C.V. Starr Biomedical Information Center, 1300 York Avenue, New York, NY 10065, USA Current Urology Reports (2020) 21:60 https://doi.org/10.1007/s11934-020-01010-0