Ureteroscopy in the elderly: safety and functional results

Area of Science:

• Urology
• Geriatric Medicine
• Surgical Outcomes

Background:

• Urinary stone disease affects a growing elderly population.
• Treatment options for elderly patients with urinary stones require careful consideration of safety and efficacy.
• Ureteroscopy (URS) is a minimally invasive option, but its use in octogenarians needs evaluation.

Purpose of the Study:

• To assess the effectiveness and safety of ureteroscopy (URS) for treating urinary stones in patients aged 80 years and above.
• To identify potential risk factors for complications in this specific patient cohort.

Main Methods:

• A retrospective review of 96 patients aged 80+ who underwent URS for urinary stone disease between 2012 and 2021.
• Analysis of patient demographics, stone characteristics, operative details, and short-term surgical outcomes.
• Evaluation of stone-free rates and complication rates using the Clavien-Dindo classification.

Main Results:

• The mean stone diameter was 10.6 mm, and the mean procedure time was 78 minutes.
• The overall stone-free rate was 73.9%.
• Minor complications occurred in 20.7% of patients, and major complications (Clavien-Dindo III-V) in 5.7%. Stone size ≥10 mm was a significant predictor of major complications (OR 1.25). Pre-operative urinary drainage did not impact outcomes.

Conclusions:

• Ureteroscopy is a relatively safe and effective procedure for managing renal and ureteral stones in elderly patients (≥80 years).
• The risk of major complications is low, with stone size ≥10 mm being the primary identified risk factor.
• Pre-operative urinary drainage strategies do not appear to influence stone-free rates or major complication incidence in this population.