RIRS in the elderly: Is it feasible and safe?

Area of Science:

• Urology
• Nephrology
• Geriatric Medicine

Background:

• Renal stone treatment efficacy and safety in elderly populations require evaluation.
• Retrograde intrarenal surgery (RIRS) is a minimally invasive option for kidney stones.

Purpose of the Study:

• To compare the safety and efficacy of RIRS in men aged 65 years and older versus those younger than 65 years.
• To identify risk factors for complications in elderly patients undergoing RIRS.

Main Methods:

• Prospective data collection from 399 male patients undergoing RIRS across 5 European centers (March 2013-March 2014).
• Comparison of perioperative outcomes and complications between elderly (≥65) and younger (<65) patient groups.
• Statistical analysis using Mann-Whitney U test, chi-squared test, Yates correction, and Fisher's exact test; univariable and multivariable analyses for complication predictors.

Main Results:

• Elderly patients (91/399) had higher ASA scores, Charlson Comorbidity Index, and prevalence of hyperlipidemia and coronary heart disease.
• No significant differences observed in stone-free rates, operative times, or re-intervention rates between the age groups.
• Similar surgical and medical complication rates (14.28% vs 9.89%) and no identified predictive factors for complications in multivariate analysis.

Conclusions:

• RIRS demonstrates comparable short-term efficacy and perioperative safety in elderly men compared to younger counterparts.
• Higher comorbidity burden in elderly patients does not translate to increased RIRS complications.
• Age alone should not be considered a contraindication or risk factor for RIRS in patients with renal stones.