Percutaneous nephrolithotomy in the elderly.
OBJECTIVE
To evaluate the success and morbidity of percutaneous nephrolithotomy (PNL) performed in patients aged 65 years and older.


METHODS
A retrospective review of 42 PNLs performed on 33 patients aged 65 years and older was compared with a cohort of 160 PNLs performed on younger patients over the same time period.


RESULTS
The presence of complete staghorn calculi (17 of 36 renal units [47%] versus 88 of 160 renal units [55%], p = 0.46) and average stone size (3.8 cm versus 4.3 cm, p = 0.2) were similar for the 2 groups. Eighty-two percent of patients (27 of 33) were stone-free or left with fragments < 5 mm at 3 months after surgery. Elderly patients had a higher transfusion rate after PNL despite similar preoperative hemoglobin levels (11 of 42 PNLs [26%] versus 22 of 160 PNLs [14%], p < 0.01). Serious complications were infrequent and there were no deaths.


CONCLUSIONS
Percutaneous nephrolithotomy is a safe and effective therapy for elderly patients with complex stone disease; however, awareness of an apparent increased requirement for blood transfusion is warranted.
Department of Urology, University of California School of Medicine, San Francisco.
M L
ML
Stoller
D
D
Bolton
M
M
St Lezin
M
M
Lawrence
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001803:Blood Transfusion; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D008096:Lithotripsy; D008297:Male; D009017:Morbidity; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy*; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome