Efficiency and Safety of The Retrograde Intrarenal Surgery in Younger Compared to Elderly Patients

Abstract

Objective: To determine the outcomes of retrograde intrarenal surgery (RIRS) and its complications in both young and elderly patients. Study Design: An observational study. Place and Duration of Study: Departments of Urology, University of Health Sciences, Ankara Research and Training Hospital, Ankara, and corum Hitit University, Corum, Turkey from April 2019 to January 2020. Methodology: Patients with kidney stones up to 3 cm in maximal diameter on computarised tomography (CT) scan, were divided into two groups according to age (<60 vs. >= 60 years ). RIRS was performed. Demographics, clinical data, and complications were recorded and compared. Results: Mean age of 78 patients was 52.47 +/- 13.28 years. There were no significant difference in gender, American Society of Anesthesiology (ASA) scores, operation time, number of multiple sessions, success rates of outcome and complication rates between groups. At the end of the first session, stone-free rates were 91.1% vs 87.9% in younger and elderly groups, respectively; while, after the second session, all patients were stone-free in both groups. Fever, hematuria (macroscopic, more than 24 hours), and perirenal hematoma were the observed complications. Postoperative hematocrit levels significantly decreased without any need of transfusion; there were significant differences in the preoperative and postoperative creatinine levels (p=0.002) in the older group. Conclusion: RIRS is a safe and effective method for treating kidney stones up to 3 centimeter diameter in all age groups. Although hemorrhagic events are mostly clinically unremarkable, there is a risk of renal function impairment in older (>= 60 years) patients. Preoperative hydration and postoperative close follow-up is important.