The Impact of Comorbidities on the Efficacy of Percutaneous Nephrolitotomy (PCNL) in Elderly Patients

Introduction: The objective of this study is to evaluate the efficacy and safety of PCNL as a method of treatment of renal stones in elderly patients.
Material and method: This was a retrospective study conducted over a period of 5 years in the Clinic of Urology, where we analyzed the surgical protocols and case reports of 56 patients who underwent PCNL intervention.
Results: The incidence of urolithiasis was higher in females 69.6 % (n = 39) than in males 30.4 % (n = 17). Comorbidities included hypertension (48.2 %), chronic ischemic cardiopathy (28.6 %), chronic cardiac failure (16.1 %), type II diabetes (17.9 %), obesity (39.3 %), chronic renal failure (8.9 %), chronic or recurrent urinary tract infections (30.4 %), history of kidney stones (21.4 %) , solitary kidney surgery (1.8%), renal malformation (horseshoe kidney and renal incomplete duplication) (3.6 %), urethral stricture (3.6 %). Nine patients had a duble “J” catheter inserted on admission. The group of male patients presented prostate hyperplasia in 35.3 % of the cases and prostate carcinoma in 5.9 % of the cases.
Conclusions: PCNL is an effective and safe treatment of kidney stones in elderly patients, with a stone- free rate increased despite existing comorbidities. The presence of comorbidities requires careful preoperative evaluation. PCNL in elderly patient has similar results to those seen in younger patients.