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Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the effects of aging on the success rate of retrograde intrarenal surgery (RIRS) and the development of medical and surgical complications by dividing geriatric patients into subgroups based on their chronological age.

Method

Data of the patients who underwent RIRS due to kidney stones at our clinic between June 2014 and January 2020 were retrospectively reviewed. Patients were divided into three groups based on age: 65–74 years (Group 1), 75–84 years (Group 2), and ≥ 85 years (Group 3). The comorbid diseases of patients were evaluated using the Charlson Comorbidity Index (CCI), total Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score, and CIRS severity index (CIRS-G SI). RIRS success rates and complications were evaluated based on age groups.

Results

A total of 336 patients were included in the study. The mean age of the patients was 72.7 ± 6.59 years. Stone-free rate was 81.5% in patients aged > 65 years and did not change with age. The modified Clavien–Dindo grade I/II complication rates for surgical complications were similar in all three groups (p = 0.818). In the evaluation of ROC analysis for medical complications, it was observed that the cut-off values were 76.5 years, CIRS-G score of 4.5, CCI score of 2.5, and CIRS-SI score of 1.18 (p < 0.001).

Conclusion

RIRS is an effective and safe treatment option for kidney and proximal ureteral stones in geriatric patients. Although there is an increase in medical complications post-RIRS with aging, surgical complications and stone-free rates remain unchanged.

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Authors and Affiliations

  1. Department of Urology, School of Medicine, Karabuk University, Karabuk, Turkey

    Aykut Aykac & Ozer Baran

Authors
  1. Aykut Aykac
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  2. Ozer Baran
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Contributions

AA contributed to conception and design, data analysis and interpretation, drafting the manuscript, and statistical analysis. OB was involved in conception and design, data acquisition, drafting the manuscript, and critical revision of the manuscript for scientific and factual content.

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Correspondence to Aykut Aykac.

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The authors declare that there is no conflict of interest.

Ethics approval

This study has been approved by Karabuk University Ethics Committee (dated November 11th, 2019, protocol number: 07/41). Written informed consent was obtained from the patients for each operation type.

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Aykac, A., Baran, O. Safety and efficacy of retrograde intrarenal surgery in geriatric patients by age groups. Int Urol Nephrol 52, 2229–2236 (2020). https://doi.org/10.1007/s11255-020-02564-1

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  • DOI: https://doi.org/10.1007/s11255-020-02564-1

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