The Comparison of Flexible Ureterorenoscopy and mini-Percutaneous Nephrolithotomy in the Treatment of 10-25 mm Kidney Stones in Elderly Patients

Abstract

Objective:The elderly population has been increasing due to extension in lifespan. Chronic comorbid disorders and medications render a recheck of the treatment modalities of urinary stones for this population. This study aimed to analyse the results of mini-percutaneous nephrolithotomy (PNL) and flexible ureterorenoscopy (F-URS), which are minimally invasive techniques for the treatment of kidney stones in elderly patients.Materials and Methods:Data of patients who are older than 65 years with 10-25-mm kidney stones and who underwent F-URS (n=51) and mini-PNL (n=33) between 2015 and 2019 were retrospectively studied. Demographic data, operative data and postoperative data were evaluated.Results:The mean age of group 1 (F-URS) was 71.5±6.4 and of group 2 (mini-PNL) 70.2±5.6 and the mean stone size was 16.1±3.8 mm for group 1 and 19.7±3.5 mm for group 2. The complete stone-free rate was similar in groups 1 and 2 at 1 month postoperatively (78.4% and 72.7%, respectively; p=0.549). Haemoglobin decrease and operation and hospitalisation time were found to be higher in group 2 (p=0.000, 0.0001, 0.002). Complication rates (transfusion-required haemorrhage, fever and colon perforation) were not statistically different between the two groups (p=0.8).Conclusion:In this study, although the stone-free rate in the F-URS and mini-PNL groups was similar, we believe that F-URS is a safer treatment method in elderly patients with 10-25-mm kidney stones than mini-PNL because of its shorter operation time and lower haemoglobin decrease.

Keywords

• flexible ureterorenoscopy
• mini-pnl
• urolithiasis