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Percutaneous nephrolithotomy in the elderly

M L Stoller1, D Bolton, M St Lezin

  • 1Department of Urology, University of California School of Medicine, San Francisco.

Urology
|November 1, 1994
PubMed
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Percutaneous nephrolithotomy (PNL) is safe and effective for elderly patients with complex kidney stones. However, older adults may require more blood transfusions after PNL.

Area of Science:

  • Urology
  • Nephrology
  • Geriatric Medicine

Background:

  • Kidney stones affect a significant portion of the population.
  • Management of complex kidney stones in elderly patients requires careful consideration of risks and benefits.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous nephrolithotomy (PNL) in patients aged 65 years and older.
  • To compare outcomes of PNL in elderly versus younger patients.

Main Methods:

  • Retrospective review of 42 PNL procedures in 33 elderly patients (≥65 years).
  • Comparison with a cohort of 160 PNL procedures in younger patients.
  • Analysis of stone characteristics, stone-free rates, and complication rates.

Main Results:

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  • Similar stone burden and size were observed between elderly and younger groups.
  • 82% of elderly patients were stone-free or had residual fragments < 5 mm at 3 months.
  • Elderly patients experienced a higher transfusion rate (26% vs. 14%, p < 0.01) despite similar preoperative hemoglobin levels.
  • Serious complications and mortality were infrequent in both groups.

Conclusions:

  • Percutaneous nephrolithotomy (PNL) is a safe and effective treatment for elderly individuals with complex kidney stones.
  • Healthcare providers should be aware of the increased need for blood transfusions in older patients undergoing PNL.