Percutaneous nephrolithotomy for staghorn kidney stones in elderly patients

We retrospectively analyzed the results of percutaneous nephrolithotomy operations for treatment of staghorn kidney stone disease in elderly patients and compared surgical parameters and outcomes with a control group of young adult patients.

Between 2002 and 2010, 300 consecutive patients underwent percutaneous nephrolithotomy operation for treatment of staghorn kidney stone disease. Forty-five of the patients were older than 65 years and considered to be in elderly group. Thirty-seven of the patients were between the ages 18 and 36 years and considered to be the control group. Surgical parameters and outcomes were compared between groups.

There were no significant differences between groups for stone area, operation time, difference in hemoglobin levels before and after surgery, blood transfusion rate, and length of hospital (P = 0.230, P = 0.106, P = 0.395, P = 0.691, and P = 0.690, respectively). Success rates after the operations were 53% in elderly group and 38% in young adult group. The difference for the outcomes of the operations was statistically insignificant (P = 0.365). Thirty-three (73%) of the patients had associated comorbid diseases in elderly group, while no patients had any comorbid disease in control group. Statistical analyses revealed no significant relation between the presence of comorbid diseases or ipsilateral renal surgery with success rate of the operation in the elderly group (P = 0.26 and P = 0.222, respectively).

The management of kidney stone disease by percutaneous nephrolithotomy in elderly patients is an adequate treatment modality even in the presence of complete staghorn calculi, comorbid diseases or previous ipsilateral renal surgery.