Does age affect outcomes of percutaneous nephrolithotomy

Abstract

The present study aimed to assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) in elderly patients. We retrospectively reviewed 50 PCNLs performed in the elderly patients (age > 65 years) carried out in our clinic from 2001 through 2007 and compared those with 248 PCNLs performed in younger patients (age < 40 years) during the same period. No significant difference was seen in calculus burden between the two groups. The success rates (stone-free patients and patients with residual calculi < 4 mm) were 85% for the elderly patients and 90% for the younger patients (P = .45). The major composition of calculi was calcium oxalate in 58% and 66.5% of the elderly and younger groups, respectively. No significant complication was observed in the elderly group. Fever without sign and symptoms of bacteremia was seen in 3 patients of each group (8.0% versus 1.2%, P = .004). The operative time was 75.0 +/- 6.4 minutes and 76.0 +/- 5.1 minutes (P = .25), and the mean hospital stay was 3.7 +/- 0.3 days and 3.8 +/- 0.9 days (P = .80) in the elderly and younger patients, respectively. We found that PCNL in patients over 65 years was a safe and reliable technique with a stone-free rate of 85% for all types of calculi. Well-controlled comorbidities do not increase the risk of operation. It seems that despite the higher medical risk in the elderly patients, PCNL could be safe and yields a high stone-free rate.