Stone-event-free survival after ureteroscopic lithotripsy by age: comparison between young and older patients

Tamiya, Takashi; Takazawa, Ryoji; Uchida, Yusuke; Waseda, Yuma; Kobayashi, Masaki; Fuse, Honoka

doi:10.1007/s00240-023-01449-z

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…Our literature review finds that URS is safe and efficacious for the octogenarian cohort. The SFR and complication rates are comparable and not dissimilar from other younger age group, as particularly described by Sinha [ 19 ] and Tamiya [ 20 ]. Comparing URS data in the elderly population and in the young (<65 years old) or very young paediatric population (<10 years), both of the studies found that surgical complication rate and successful events were similar in the different age groups.…”

Section: Discussionsupporting

confidence: 67%

“…The stone size stayed relatively similar throughout the studies, with the mean ranging from 7.37 mm −13.4 mm. The stone density was reported in three of the studies [ 16 , 17 , 20 ] with a mean range of 570 HU to 940 HU. The stone location was in the ureter ( n = 449), kidney ( n = 413), with 38.5% patients having stones in multiple locations.…”

Section: Resultsmentioning

confidence: 99%

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Is ureteroscopy and active stone treatment safe and effective in octogenarians? A review of current literature

Bhatnagar,

Nedbal,

Somani

2024

Arab Journal of Urology

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Background With the aging of our patient population, and the increasing incidence of kidney stone disease in the elderly, active stone treatment is becoming more common. In this review of current literature, we aim to assess safety and efficacy of ureteroscopy (URS) as primary treatment for urolithiasis in the octogenarians. Materials and methods A scoping review of literature according to the PRISMA guidelines was performed, using the relevant search terms. Original articles were screened and included. A narrative review of the studies is provided, with emphasis on outcomes of URS in the elderly. Results 10 studies were included in the analysis. URS performed in the elderly population showed a good safety and efficacy, with stone-free rates (SFR) comparable to the general population. URS specific complication rates seems to be comparable to the other age groups, with postoperative events mostly related to anaesthesia and pre-existing medical conditions. The overall complication rate was still low, with a slightly prolonged hospital stay. Predictors for SFR were age, severe comorbidities and stone burden. Conclusion URS for stone treatment in the elderly population is safe and effective, with comparable surgical outcomes to that of the general population. As comorbidities play an important role in the fitness for surgery and overall survival, risks and benefit of active stone treatment should be carefully balanced in this group.

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Section: Discussionsupporting

confidence: 67%

Section: Resultsmentioning

confidence: 99%

Is ureteroscopy and active stone treatment safe and effective in octogenarians? A review of current literature

Bhatnagar,

Nedbal,

Somani

2024

Arab Journal of Urology

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“…Though age was a statistically signi cant predictor, the odds ratio trended to zero, thus hinting that this association may not be of clinical relevance. Studies have previously shown SFR to be comparable between younger and older patients [9].…”

Section: Discussionmentioning

confidence: 90%

Exploring the use of suction evacuation sheath for surgical treatment of renal stones during ureteroscopy: An analysis of 2284 cases

Kolanukuduru,

Mandel,

Tillu

et al. 2024

Preprint

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Stone-free rates have drastically improved due to technological advancements in the field of endourology. One such advancement has been the use of suction evacuation sheaths (SES) during ureteroscopy (URS). Studies about outcomes after SES URS have been limited by small sample sizes. Here, we performed an analysis of postoperative outcomes of 2284 patients who underwent SES URS for the treatment of renal stone disease. We found that 86% of patients were stone-free at one month, with 50% of patients not requiring any repeat procedures for stone clearance. 1.28% experienced a major complication (Clavien-Dindo ≥ 3); 4.6% had postoperative fever, and 1.28% experienced sepsis after surgery. Ureteral injuries were seen in 1.5% of patients. Stone burden (OR 0.45 [0.33–0.62]) and the requirement of stent placement after lithotripsy (OR 0.71 [0.54–0.95]) were associated with lower SFR, while the use of basket during URS doubled the chances of being stone-free (OR 2.17 [1.33–3.53]). Age, while statistically significant, was not clinically relevant (OR 0.97 [0.96–0.98]). Our study is limited by its retrospective nature and the absence of a comparator group. Nonetheless, this study represents the largest cohort of patients to undergo SES URS for renal stone disease, and demonstrates that SES URS is a safe and efficacious technique for stone removal, with an SFR of 86% at one-month, and a 1.28% sepsis rate after surgery. Manual stone extraction in these patients can double their chances of being stone-free, thus highlighting that the use of SES alone is insufficient during URS.

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Stone-event-free survival after ureteroscopic lithotripsy by age: comparison between young and older patients

Cited by 2 publications

References 14 publications

Is ureteroscopy and active stone treatment safe and effective in octogenarians? A review of current literature

Is ureteroscopy and active stone treatment safe and effective in octogenarians? A review of current literature

Exploring the use of suction evacuation sheath for surgical treatment of renal stones during ureteroscopy: An analysis of 2284 cases

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