Percutaneous nephrolithotomy in patients aged 60 years or older

Purpose: To assess the safety and efficacy of percutaneous nephrolithotomy in patients more than 60 years old. Patients and Methods: We retrospectively evaluated and compared the data of 28 percutaneous nephrolithotomies (PCNL) performed on 27 patients aged 60 years and older (mean 65.8) with the data of the remaining 178 PCNL procedu res on 166 patients performed in our clinic between December 1997 and Decem ber 1999, Results: Although staghorn stones seemed to be more common in the elderly g roup (25% v 22%), no statistical significance was demonstrated (P = 0.715), and the stone burden was similar for the two groups (P = 0.112), The only interesting finding in terms of patient characteristics was a significantly higher incidence of solitary kidney in patients aged 60 years or older (29 % v 7%; P = 0.003). The success rates (stone-free patients and patients wit h residual stones <4 mm) were similar, being 89% for the elderly group and 92% for the younger patients (P = 0.718). Transfusion rates were also simil ar (21.4% in the elderly v 18% in the younger group; P = 0.662), No signifi cant complication was observed in this elderly group, and no renal deterior ation has been detected even in the follow-up of patients with a solitary k idney. Conclusions: Despite the somewhat higher stone burden in the elderly patien ts (1077.92 mm(2) v 920.85 mm(2)), the stone-free rate was similar to that obtained in the younger patients, without any higher rates of complications or blood transfusions or longer hospital stay. Percutaneous nephrolithotom y is a safe and effective method of stone treatment in the elderly, even if they have a solitary kidney or complex calculi.