Efficacy and Safety of Percutaneous Nephrolithotomy in Patients Over 70 Years with Kidney Stones

Open access


Introduction and objectives: Percutaneous nephrolithotomy represent the main indication for patients with kidney stones, even in the presence of various comorbidities. In our clinic open surgery for this pathology is less than 0.5% of all procedures for renal stones. The objective of this paper is to assess the safety and efficacy of this procedure in patients over 70 years.

Material and methods: A retrospective study was performed for a period of 16 years (1997-2012). A totally of 323 patients entered in this study (162 women, 161 men), aged over 70 and with renal stones They were treated endoscopically by percutaneous nephrolithtomy or anterograde ureteroscopy. 85 patients (26.31%) had comorbidities that were preoperatively diagnosed and treated where necessary.

Results: Overall status of “stone free” at the end of surgery was present in 263 patients (81.42%). 60 patients (18.58%) had residual fragments. Residual stones were solved by a new percutaneuos nephrolithtomy session, spontaneous elimination or extracorporeal shock wave lithotripsy. The most common complications were bleeding and infection. We had no deaths. No hemostasis nephrectomy was necessary.

Conclusions: Recognized preoperative comorbidities do not represent risk factors in elderly patients, but it requires a rigorous evaluation in the preoperative period. The number, size and complexity of stones directly influences the state “stone free” at the end of surgery.

1. Kamphuis GM, Baard J, de la Rosette JJ, et al. Lessons learned from the CROES percutaneous nephrolithotomy global study. World J Urol, 2015;33:223-233.

2. Sahin A, Atsu N, Ersem E, et al. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2001;15:489-491.

3. Reynard J, Brewster S, Biers S. Oxford Handbook of Urology, 3rd ed. Oxford University Press, 2013;428-460.

4. Sheir KZ, Cad HM. Prospective study of the effects of shock wave lithotripsy on renal function: role of postshock wave lithotripsy obstruction. Urology, 2003;61:1102-1106.

5. Anagnostou T, Thompson T. Safety and outcome of percutaneous nephrolithotomy in the elderly: retrospective comparison to a younger patient group. J Endourol. 2008;22:2139-2145.

6. Segura JW, Preminger GM, Assimos DG, et al. Nephrolithiasis clinical guidelines panel summary report on the management of staghorn calculi. J Urol. 2010;151:1648-1651.

7. BojaR. Chirurgia percutanata reno-ureterala. Ed. Leda&Muntenia, Constanta, 2000:77-78.

8. Mullholland CK, Kernohan RM. Splitting the Amplatz sheath to facilitate percutaneous stone extractions. Br J Urol. 1994,74:375-376.

9. Karami H, Mohsen M, Golshan A, et al. Does age affect outcomes of percutaneous nephrolithotomy? J Urol. 2010;7:17-21.

10. Belabay MD, Varogh E, Devrine H, et al. Qualitative evolution of renal parenchymal mass with 99m technetium dimercapto-succinic acid scintigraphy after nephrolothotomy. J Urol. 1997;157:1226-1228.

11. Kukreja RA, Desai MR, Sabnis RB, Patel SH. Fluid absorbtion during percutaneous nephrolithotomy: does it matter? J Endourol. 2002;16:221-224.

Acta Medica Marisiensis

The Journal of The University of Medicine and Pharmacy of Targu-Mures

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 106 105 7
PDF Downloads 49 48 5