Introduction and Objectives
To investigate the effect of percutaneous nephrolithotomy (PCNL) in the treatment of staghorn renal stones in geriatric patients.
Material and Methods
Between 2002–2009, 40 geriatric patients (22 male, 18 female), whose ages were above 65 years, underwent 42 PCNL operations for the treatment of staghorn kidney stones. The stone area, operation time, delta hemoglobin (ΔHb: calculated by substracting postoperative Hb level from preoperative Hb level), stone clearance rates and additional treatment rates were investigated.
Results
The mean age of the patients was 69±3.5 years. Twenty eight (70%) of the patients had at least one of the comorbide diseases including diabetes mellitus, hypertension, atherosclerotic coronary artery disease and five (11.9%) had initial ipsilateral renal surgery in history. The mean stone area was 1668.5±629.4 mm2. Two patients underwent bilateral PCNL. The mean operation time was 137.5±33.9 minutes and mean hospitalization time was 3.9±2.3 days. Mean ΔHb was 1.49±1.29 gr/dl. At the end of the operations, stone clearance rates were stone free in 12 (28.6%), clinically insignificant residue fragments in 8 (19%), clinically significant residue fragments in 22 (52.4%) renal units. Thus, 18 (45%) patients requested an additional treatment after PCNL; 3 (7%) second-look PCNL and 15 (38%) Shock Wave Lithotripsy. No perioperative complications were seen.
Conclusions
PCNL is safe and effective for treatment of staghorn kidney stones in geriatric patients, however, additional treatment modalities can be needed.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
