Does age affect outcomes of percutaneous nephrolithotomy?

Urol J. Winter 2010;7(1):17-21.

Abstract

Introduction: The present study aimed to assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) in elderly patients.

Materials and methods: We retrospectively reviewed 50 PCNLs performed in the elderly patients (age > 65 years) carried out in our clinic from 2001 through 2007 and compared those with 248 PCNLs performed in younger patients (age < 40 years) during the same period.

Results: No significant difference was seen in calculus burden between the two groups. The success rates (stone-free patients and patients with residual calculi < 4 mm) were 85% for the elderly patients and 90% for the younger patients (P = .45). The major composition of calculi was calcium oxalate in 58% and 66.5% of the elderly and younger groups, respectively. No significant complication was observed in the elderly group. Fever without sign and symptoms of bacteremia was seen in 3 patients of each group (8.0% versus 1.2%, P = .004). The operative time was 75.0 +/- 6.4 minutes and 76.0 +/- 5.1 minutes (P = .25), and the mean hospital stay was 3.7 +/- 0.3 days and 3.8 +/- 0.9 days (P = .80) in the elderly and younger patients, respectively.

Conclusion: We found that PCNL in patients over 65 years was a safe and reliable technique with a stone-free rate of 85% for all types of calculi. Well-controlled comorbidities do not increase the risk of operation. It seems that despite the higher medical risk in the elderly patients, PCNL could be safe and yields a high stone-free rate.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Kidney Calculi / therapy*
  • Male
  • Nephrostomy, Percutaneous*
  • Retrospective Studies
  • Treatment Outcome