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Review
. 2023 Apr;41(4):981-992.
doi: 10.1007/s00345-023-04333-y. Epub 2023 Mar 1.

Management of large kidney stones in the geriatric population

Alison E Schulz  1 , Benjamin W Green  1 , Kavita Gupta  2 , Rutul D Patel  2 , Justin Loloi  2 , Dima Raskolnikov  2 , Kara L Watts  2 , Alexander C Small  3
Affiliations
Review

Management of large kidney stones in the geriatric population

Alison E Schulz et al. World J Urol. 2023 Apr.

Abstract

Purpose: The aim of this review is to highlight the unique factors that predispose geriatric patients to nephrolithiasis and to compare the utility and efficacy of surgical techniques in this specific patient population.

Methods: PubMed and EMBASE databases were reviewed, and studies were organized according to surgical treatments.

Results: Few prospective studies exist comparing kidney stone removal in the elderly to younger cohorts. In addition, various age cut-offs were used to determine who was considered elderly. Most studies which analyzed Percutaneous Nephrolithotomy (PCNL) found a slightly higher rate of minor complications but comparable stone free rate and operative time. For ureteroscopy (URS) and extracorporeal shockwave lithotripsy (ESWL), there were minimal complications observed and no difference in clinical success in the elderly. All surgical techniques were presumed to be safe in the elderly and most found no difference in stone-free rates.

Conclusions: Unique attributes of the geriatric population contribute to stone formation and must be considered when determining appropriate management modalities. This review provides an overview of the utility and efficacy of PCNL, URS and ESWL in the elderly, as well as a porposed algorithm for management in this population.

Keywords: Elderly; Geriatric; Kidney stones; Nephrolithiasis; Staghorn.

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Comment in

  • Urolithiasis/Endourology.
    Assimos DG. Assimos DG. J Urol. 2023 Dec;210(6):924-926. doi: 10.1097/JU.0000000000003663. Epub 2023 Sep 29. J Urol. 2023. PMID: 37774380 No abstract available.

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