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Ureteroscopy and stone treatment in the elderly (≥70 years): prospective outcomes over 5- years with a review of literature

Ureteroscopy and stone treatment in the elderly (≥70 years): prospective outcomes over 5- years with a review of literature
Ureteroscopy and stone treatment in the elderly (≥70 years): prospective outcomes over 5- years with a review of literature

OBJECTIVE: To assess outcomes of ureteroscopy for treatment of stone disease in the elderly. Ureteroscopy (URS) is an increasingly popular treatment modality for urolithiasis and its applications are ever expanding with the development of newer technologies. Its feasibility and outcomes within the elderly population to our knowledge remain under-reported.

MATERIALS AND METHODS: We examined the patient demographics and surgical outcomes from our prospective database for patients ≥70 years who underwent URS for urolithiasis, in a 5-year period between March 2012 and December 2016.

RESULTS: A total of 110 consecutive patients underwent 121 procedures (1.1 procedure/ patient) with a mean age of 77.2 years (range: 70-91 years). Stone location was in the kidney/ pelviureteric junction (PUJ) in 29%, ureter in 37% and in multiple locations in 34%. The initial and final stone free rate (SFR) was 88% and 97% respectively. While 73% were done as true day case procedures, 89% patients were discharged within 24 hours. Eleven patients (9%) underwent complications of which 10 were Clavien I/II including acute urinary retention, urinary tract infection, stent symptoms and pneumonia. One patient underwent Clavien IV complication where they needed intensive care unit admission for urosepsis but fully recovered and were discharged home subsequently.

CONCLUSION: Ureteroscopy is a safe and effective method of managing urolithiasis in elderly patients. Although most patients are discharged within 24-hours, consideration needs to be made for patients where social circumstances can impact their discharge planning.

Journal Article
1677-5538
Prattley, Sarah
fe166d46-f5d3-4d84-838f-10eee44f85d5
Voss, James
348679e0-2b5a-4802-8f7b-13f9676197bd
Cheung, Stephanie
eea6df8a-f1bc-4984-b4a1-68faf03ab3df
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Jones, Patrick
d27beb5b-0e09-4ed5-89f0-6c62421c2397
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Prattley, Sarah
fe166d46-f5d3-4d84-838f-10eee44f85d5
Voss, James
348679e0-2b5a-4802-8f7b-13f9676197bd
Cheung, Stephanie
eea6df8a-f1bc-4984-b4a1-68faf03ab3df
Geraghty, Robert
ef19149e-530f-4749-9740-0902fed96fe1
Jones, Patrick
d27beb5b-0e09-4ed5-89f0-6c62421c2397
Somani, Bhaskar K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Prattley, Sarah, Voss, James, Cheung, Stephanie, Geraghty, Robert, Jones, Patrick and Somani, Bhaskar K. (2018) Ureteroscopy and stone treatment in the elderly (≥70 years): prospective outcomes over 5- years with a review of literature. International Brazilian Journal of Urology, 44. (doi:10.1590/S1677-5538.IBJU.2017.0516).

Record type: Article

Abstract

OBJECTIVE: To assess outcomes of ureteroscopy for treatment of stone disease in the elderly. Ureteroscopy (URS) is an increasingly popular treatment modality for urolithiasis and its applications are ever expanding with the development of newer technologies. Its feasibility and outcomes within the elderly population to our knowledge remain under-reported.

MATERIALS AND METHODS: We examined the patient demographics and surgical outcomes from our prospective database for patients ≥70 years who underwent URS for urolithiasis, in a 5-year period between March 2012 and December 2016.

RESULTS: A total of 110 consecutive patients underwent 121 procedures (1.1 procedure/ patient) with a mean age of 77.2 years (range: 70-91 years). Stone location was in the kidney/ pelviureteric junction (PUJ) in 29%, ureter in 37% and in multiple locations in 34%. The initial and final stone free rate (SFR) was 88% and 97% respectively. While 73% were done as true day case procedures, 89% patients were discharged within 24 hours. Eleven patients (9%) underwent complications of which 10 were Clavien I/II including acute urinary retention, urinary tract infection, stent symptoms and pneumonia. One patient underwent Clavien IV complication where they needed intensive care unit admission for urosepsis but fully recovered and were discharged home subsequently.

CONCLUSION: Ureteroscopy is a safe and effective method of managing urolithiasis in elderly patients. Although most patients are discharged within 24-hours, consideration needs to be made for patients where social circumstances can impact their discharge planning.

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More information

e-pub ahead of print date: 9 March 2018
Additional Information: Copyright® by the International Brazilian Journal of Urology.
Keywords: Journal Article

Identifiers

Local EPrints ID: 419261
URI: http://eprints.soton.ac.uk/id/eprint/419261
ISSN: 1677-5538
PURE UUID: bbd27a0e-9bbb-4201-984d-61b9ad84734b

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Date deposited: 09 Apr 2018 16:30
Last modified: 08 Aug 2018 16:31

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Contributors

Author: Sarah Prattley
Author: James Voss
Author: Stephanie Cheung
Author: Robert Geraghty
Author: Patrick Jones

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