Abstract
The aim of this study is to examine stone-event-free survival after ureteroscopic lithotripsy (URSL) and risk factors for stone events by age. We retrospectively collected data of all URSL cases at our institution from 2008 to 2021. A total of 1334 cases were included and divided into young (< 65 years, 792 cases), young-old (65–74 years, 316 cases), old-old (75–84 years, 172 cases), and oldest-old (≥ 85 years, 54 cases) groups. Patient characteristics, surgical outcomes, and postoperative stone events were evaluated. The stone-event-free survival and risk factors were compared between young and older groups. Overall, 214 (16.0%) cases developed stone events during a mean follow-up period of 763 days and the 2-year, 5-year, and 8-year stone-event-free survival rates were 84.5%, 72.2%, and 57.2%, respectively. The numbers of stone events in young, young-old, old-old, oldest-old groups were 133 (16.8%), 53 (16.8%), 21 (12.2%), and 7 (13.0%), respectively. No significant differences were found in stone-event-free survival between the young group and each of the older groups. Residual fragment > 4 mm and stone burden ≥ 15 mm were common risk factors in both young and older groups. Especially in older patients, preoperative stenting, which was most often performed to treat obstructive pyelonephritis, was the third risk factor. In conclusion, stone-event-free survival after URSL was comparable between young and older patients. Residual fragment > 4 mm and stone burden ≥ 15 mm were common risk factors in both groups. Preoperative stenting was an additional risk factor in older patients, suggesting that urinary tract infection may influence stone events.
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The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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All authors contributed to the study conception and design. Material preparation and data collection were performed by all authors. The first draft of the manuscript was written by TT and RT. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The protocol for this research project has been approved by a suitably constituted Ethics Committee of Tokyo Metropolitan Ohtsuka Hospital (approval number 2020-62) and it conforms to the provisions of the Declaration of Helsinki.
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Tamiya, T., Takazawa, R., Uchida, Y. et al. Stone-event-free survival after ureteroscopic lithotripsy by age: comparison between young and older patients. Urolithiasis 51, 74 (2023). https://doi.org/10.1007/s00240-023-01449-z
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DOI: https://doi.org/10.1007/s00240-023-01449-z