Skip to main content

Advertisement

SpringerLink
Log in

Active stone removal is a safe option for ocotogenarians and nonagenarians with nephrolithiasis

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 01 April 2023

Abstract

Purpose

To assess the contemporary in-hospital management of octogenarians and nonagenarians with renal calculi.

Material and Methods

A multicentric retrospective evaluation of patients aged ≥ 80 years hospitalized with kidney stones between 01/2000 and 12/2019. Stone and patient related data were collected, including stone size and location, geriatric status and comorbidities. Surgical treatment patterns and outcome were assessed.

Results

A total of 299 patients (57% female) with kidney stones were analyzed. Mean age was 84.7 years. Patients were largely multimorbid (ASA ≥ 3 in 70%) and about 25% were classified as frail. Active stone treatment was performed in 65% and 35% were treated with urinary diversion (stent or nephrostomy). Prognostic factors for receiving an active stone treatment were age < 90 years, male sex, stone size and quantity, and performance status. Mean overall survival was 23.7 months and when stratified to treatment mean survival were 21 months after urinary diversion, 28 months after URS, 29 months after PCNL and 45 months after SWL.

Conclusion

Age, frailty and performance-status as well as stone size and quantity are predictors for active stone treatment. Octogenarians and nonagenarians, who are considered fit for surgery, tend to live long enough to profit from active stone treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Abufaraj M, Xu T, Cao C, Waldhoer T, Seitz C, D’Andrea D et al (2021) Prevalence and trends in kidney stone among adults in the USA: analyses of national health and nutrition examination survey 2007–2018 data. Eur Urol Focus 7(6):1468–1475

    Article  PubMed  Google Scholar 

  2. Hesse A, Brandle E, Wilbert D, Kohrmann KU, Alken P (2003) Study on the prevalence and incidence of urolithiasis in Germany comparing the years 1979 vs. 2000. Eur Urol 44(6):709–713

    Article  CAS  PubMed  Google Scholar 

  3. Beard JR, Officer A, de Carvalho IA, Sadana R, Pot AM, Michel JP et al (2016) The World report on ageing and health: a policy framework for healthy ageing. Lancet 387(10033):2145–2154

    Article  PubMed  Google Scholar 

  4. Eredics K, Luef T, Madersbacher S (2021) The future of urology: nonagenarians admitted to a urological ward. World J Urol 39(9):3671–3676

    Article  PubMed  Google Scholar 

  5. Knoll T, Schubert AB, Fahlenkamp D, Leusmann DB, Wendt-Nordahl G, Schubert G (2011) Urolithiasis through the ages: data on more than 200,000 urinary stone analyses. J Urol 185(4):1304–1311

    Article  PubMed  Google Scholar 

  6. Daels FP, Gaizauskas A, Rioja J, Varshney AK, Erkan E, Ozgok Y et al (2015) Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol 33(6):859–864

    Article  CAS  PubMed  Google Scholar 

  7. Jablonski SG, Urman RD (2019) The growing challenge of the older surgical population. Anesthesiol Clin 37(3):401–409

    Article  PubMed  Google Scholar 

  8. Turk C, Petrik A, Sarica K, Seitz C, Skolarikos A, Straub M et al (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482

    Article  PubMed  Google Scholar 

  9. Aykac A, Baran O (2020) Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups. Int Urol Nephrol 52(12):2229–2236

    Article  PubMed  Google Scholar 

  10. Emiliani E, Piccirilli A, Cepeda-Delgado M, Kanashiro AK, Mantilla D, Amaya CA et al (2021) Flexible ureteroscopy in extreme elderly patients (80 years of age and older) is feasible and safe. World J Urol 39(7):2703–2708

    Article  CAS  PubMed  Google Scholar 

  11. Gokcen K, Dundar G, Bagcioglu M, Karagoz MA, Gokce G, Sarica K (2020) Safety and efficacy of RIRS in geriatric patients: a comparative evaluation on an age based manner. Urol J 17(2):129–133

    PubMed  Google Scholar 

  12. Mager R, Brauers C, Kurosch M, Dotzauer R, Borgmann H, Haferkamp A (2022) Outcomes for geriatric urolithiasis patients aged ≥80 years compared to patients in their seventies. Eur Urol Focus 8(4):1103–1109. https://doi.org/10.1016/j.euf.2021.08.004. (Epub 2021 Aug 26)

    Article  PubMed  Google Scholar 

  13. Morganstern B, Galli R, Motamedinia P, Leavitt D, Keheila M, Ghiraldi E et al (2015) Percutaneous nephrolithotomy in octogenarians and beyond: How old is too old? Asian J Urol 2(4):208–213

    Article  PubMed  PubMed Central  Google Scholar 

  14. Prattley S, Voss J, Cheung S, Geraghty R, Jones P, Somani BK (2018) Ureteroscopy and stone treatment in the elderly (≥70 years): prospective outcomes over 5- years with a review of literature. Int Braz J Urol 44(4):750–757

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yamashita S, Kohjimoto Y, Hirabayashi Y, Iguchi T, Iba A, Higuchi M et al (2017) Upper urinary tract stone disease in patients with poor performance status: active stone removal or conservative management? BMC Urol 17(1):103

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kino M, Hayashi T, Hino D, Nakada T, Kitoh H, Akakura K (2021) Patients’ poor performance status is an independent risk factor for urosepsis induced by kidney and ureteral stones. Urolithiasis 49(5):477–484

    Article  CAS  PubMed  Google Scholar 

  17. Atalay HA, Canat L, Bayraktarli R, Alkan I, Can O, Altunrende F (2018) Evaluation of stone volume distribution in renal collecting system as a predictor of stone-free rate after percutaneous nephrolithotomy: a retrospective single-center study. Urolithiasis 46(3):303–309

    Article  PubMed  Google Scholar 

  18. Kokov D, Manka L, Beck A, Winter A, Gerullis H, Karakiewicz PI et al (2019) Only size matters in stone patients: computed tomography controlled stone-free rates after mini-percutaneous nephrolithotomy. Urol Int 103(2):166–171

    Article  PubMed  Google Scholar 

  19. Maugeri O, Dalmasso E, Peretti D, Venzano F, Chiapello G, Ambruosi C, et al. (2021) Stone free rate and clinical complications in patients submitted to retrograde intrarenal surgery (RIRS): Our experience in 571 consecutive cases. Archivio Italiano Di Urologia Andrologia 93(3):313–7.

  20. Detweiler K, Mayers D, Fletcher SG (2015) Bacteruria and urinary tract infections in the elderly. Urol Clinics N Am 42(4):561–568

    Article  Google Scholar 

  21. Kitano H, Shigemoto N, Koba Y, Hara T, Seiya K, Omori K et al (2021) Indwelling catheterization, renal stones, and hydronephrosis are risk factors for symptomatic Staphylococcus aureus-related urinary tract infection. World J Urol 39(2):511–516

    Article  CAS  PubMed  Google Scholar 

  22. Suskind AM, Walter LC, Zhao S, Finlayson E (2017) Functional outcomes after transurethral resection of the prostate in nursing home residents. J Am Geriatr Soc 65(4):699–703

    Article  PubMed  Google Scholar 

  23. Joshi HB, Adams S, Obadeyi OO, Rao PN (2001) Nephrostomy tube or “JJ” ureteric stent in ureteric obstruction: assessment of patient perspectives using quality-of-life survey and utility analysis. Eur Urol 39(6):695–701

    Article  CAS  PubMed  Google Scholar 

  24. Koprowski C, Kim C, Modi PK, Elsamra SE (2016) Ureteral stent-associated pain: a review. J Endourol 30(7):744–753

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Urology, Paracelsus Medizinische Privatuniversität Salzburg, Strubergasse 21, 5020, Salzburg, Austria

    Klaus Eredics, Martin Drerup, Christian Ramesmayer & Stephan Seklehner

  2. Department of Urology, Krankenhaus der Barmherzigen Brüder Salzburg, Kajetanerplatz 1, 5010, Salzburg, Austria

    Martin Drerup

  3. UROMED KompetenzZentrum Urologie, Neubaugürtel 47/OG5, 1150, Vienna, Austria

    Mehmet Özsoy

  4. Department of Urology, Klinik Donaustadt, Langobardenstraße 122, 1220, Vienna, Austria

    Klaus Eredics & Clemens Wehrberger

  5. Department of Urology, Universitätsklinikum Krems an der Donau, Mitterweg 10, 3500, Krems an der Donau, Austria

    Matthias Lenz

  6. Department of Urology, Tauernklinikum Zell am See, Paracelsusstraße 8, 5700, Zell am See, Austria

    Philipp Stolzlechner

  7. Department of Urology, Medizinische Universität Innsbruck, Christoph-Probst-Platz 1, Innrain 52 A, Fritz-Pregl-Straße 3, 6020, Innsbruck, Austria

    Johannes Zanier

  8. Department of Urology, Klinik Favoriten, Kundratstraße 3, 1100, Vienna, Austria

    Claudia E. Falkensammer

  9. Department of Urology, Klinikum Klagenfurt am Wörthersee, Feschnigstraße 11, 9020, Klagenfurt am Wörthersee, Austria

    Ivan Handjiev

  10. Department of Urology, Landesklinikum Baden-Mödling, Waltersdorferstraße 75, 2500, Baden bei Vienna, Austria

    Andreas Wasserscheid & Stephan Seklehner

Authors
  1. Klaus Eredics
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Drerup
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mehmet Özsoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Clemens Wehrberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthias Lenz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christian Ramesmayer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Philipp Stolzlechner
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Johannes Zanier
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Claudia E. Falkensammer
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ivan Handjiev
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Andreas Wasserscheid
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Stephan Seklehner
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

KE: data analysis and management, manuscript writing; MD: data collection, data analysis; MÖ: project development, manuscript revision; CW: project development, data collection; ML: data collection; CR: data collection; PS: data collection; JZ: data collection; CEF: data collection; IH: data collection; AW: data collection; SS: project development, data analysis and management, manuscript writing.

Corresponding author

Correspondence to Klaus Eredics.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants

The paper does not report on primary research. All data analyzed were collected as part of routine diagnosis and treatment. The Ethics Committee of the City of Vienna waived the need for ethics approval and the need to obtain consent for the collection, analysis and publication of the retrospectively obtained and anonymized data for this non-interventional study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Eredics, K., Drerup, M., Özsoy, M. et al. Active stone removal is a safe option for ocotogenarians and nonagenarians with nephrolithiasis. World J Urol 41, 849–856 (2023). https://doi.org/10.1007/s00345-023-04304-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-023-04304-3

Keywords

Search

Navigation