Comparison of the results of percutaneous nephrolithotomy in different age groups


  • Ali Borekoglu Department of Urology, Mersin City Hospital, Mersin, Turkey
  • Ibrahim Atilla Aridogan Department of Urology, Faculty of Medicine, University of Çukurova, Adana, Turkey
  • Mutlu Deger Department of Urology, Faculty of Medicine, University of Çukurova, Adana, Turkey
  • Onur Karsli Department of Urology, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
  • Volkan Izol Department of Urology, Faculty of Medicine, University of Çukurova, Adana, Turkey



Geriatric, Kidney stone, PCNL, Complication


Background: Evaluation of feasibility, safety and effectiveness of percutaneous nephrolithotomy (PCNL) in different age groups.

Methods: Between July 1997-October 2012, 233 patients who were 65 years old and older were included in this study. These patients were divided into two age subgroups used in gerontology research. Group 1 was defined as patients 65-74 years old, Group 2 was older than 74 years old. Data from patient records, including demographic characteristics, preoperative evaluation, operative details, and complications were retrospectively analyzed and compared with control group data.

Results: The mean age of 233 patients was 69.7±4.6 years. The mean operative times for Group 1, group 2 and the control group were 76.2±47.3mins, 92.9±47.6mins, 77±44mins, respectively and there was no statistically significant difference between groups 1 and 2 and the control group (p>0.05). Twenty-eight of the 233 patients (12%) needed blood transfusion due to perioperative bleeding. The transfusion rates of groups 1 and 2 were 11.3% and 16.7%, respectively. There was no statistically significant difference between the study groups and control group for blood transfusion rates (p>0.05). There was no statistically significant difference in complications between the study and control groups (p>0.05).

Conclusions: In geriatric patients, stone-free rates, transfusion rates and other operation parameters are similar to younger populations when experienced surgeons perform PCNL. Despite comorbidities and decreased body reserve, PCNL can be performed without a significant increase in complications in different ages.


Fernstrom I, Johanson B. Percutaneous pyelolithotomy. Scand J Urol Nephrol. 1976;10:257.

Citamak B, Altan M, Bozaci AC, Koni A, Dogan HS, Bilen CY, Sahin A, TekgulS. Percutaneous Nephrolithotomy in Children: 17 Years of Experience. J Urol. 2016;195(4):1082-7.

Izol V, Aridogan IA, Borekoglu A, Gokalp F, Hatipoglu Z, Bayazit Y, et al. Percutaneous nephrolithotomy in prone position in patients with spinal deformities. Int J Clin Exp Med 2015;158(11):21053-61.

Ozgor F, Ucpinar B, Binbay M. Effect of Obesity on Prone Percutaneous Nephrolithotomy Outcomes: A Systemic Review. Urol J. 2016;513(1):2471-8.

Hu H, Lu Y, He D, Cui L, Zhang J, Zhao Z, Qin B, Wang Y, Lin F, Wang S. Comparison of minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy for the treatment of intermediate proximal ureteral and renal stones in the elderly. Urolithiasis. 2016;44(5):427-34.

Ozturk H. Tubeless versus standard PCNL in geriatric population. Actas Urol Esp. 2015;39(8):494-501.

Tok A, Ozturk S, Tepeler A, Tefekli AH, Kazancioglu R, Muslumanoglu AY. The effects of percutaneous nephrolithotomy on renal function in geriatric patients in the early postoperative period. Int Urol Nephrol. 2009;41(1):219-23.

WHO. Psychogeriatric, report of a WHO scientific group. Technical Reports Series 507, Genava, Cited in Davise AM Epidemiology. 1972:9-21.

WHO. The uses of epidemiology in the study of the elderly. Technical Reports Series 706, Genava;1984:8-9

Alyami F, Norman RW. Is an overnight stay after percutaneous nephrolithotomy safe? Arab J Urol. 2012;10(4):367-71.

Stoller ML, Bolton D. Percutaneous nephrolithotomy in the elderly. Urology. 1994;44:651-4.

Ng CF. The effect of age on outcomes in patients undergoing treatment for renal stones. Curr Opin Urol 2009;19:211-4.

Dore B, Conort P. Percutaneous nephrolithotomy (PCNL) in subjects over the age of 70: a multicentre retrospective study of 210 cases. Prog Urol. 2004;14:1140-5.

Gupta M, Bolton DM. Improved renal function following aggressive treatment of urolithiasis and concurrent mild to moderate renal insufficiency. J Urol. 1994;152:1086-90.

Anagnostou T, Thompson T, Ng CF. Safety and outcome of percutaneous nephrolithotomy in the elderly: retrospective comparison to a younger patient group. J Endourol. 2008;22:2139-45.

Sahin A, Atsu N. Percutaneous nephrolithotomy in patients aged 60 years or older. J Endourol. 2000;15:489-91.

Wilson WT, Husmann DA. A comparison of the bioeffects of four different modes of stone therapy on renal function and morphology. J Urol. 1993;150:1267-70.

Kandel LB. Treatment of renal calculi in the elderly. Am J Kidney Dis. 1990;16:329–31.

Patterson DE, Segura JW, Le Roy AJ. The etiology and treatment of delayed bleeding following percutaneous lithotripsy. J Urol. 1985;133:447.

Okeke Z, Arthur D. Prospective comparison of outcomes of percutaneous nephrolithotomy in elderly patients versus younger patients. J Urol. 2012;26:996-1001.

Jones DJ, Kellett MJ. Percutaneous nephrolithotomy and the solitary kidney. J Urol. 1991;145:477.






Original Research Articles