Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients


Submitted: September 14, 2020
Accepted: October 27, 2020
Published: December 18, 2020
Abstract Views: 836
PDF: 394
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Objective: In this study, it was aimed to evaluate the efficacy and safety of SWL treatment in elderly patients with kidney stones. Materials and methods: Data from a total of 3024 patients who underwent SWL treatment for urinary tract stone disease in three centers of our university were evaluated retrospectively. A total of 1433 patients in the adult age group treated for single kidney stones were included in the study. The patients were divided into 3 groups (18-40, 41-64 and ≥ 65) years depending on their age. Demographic data, stone parameters, stone-free rate (SFR) and clinically insignificant residual fragment (CIRF) rate, number of SWL sessions and complication rate were analyzed according to the age groups. Results: The mean age of the patients was 47.38 ± 13.24 years. Stone size was significantly lower in the 18-40 years age group compared to other groups (p = 0.000) and the stones were mostly located on the right side in this age group (p = 0.007). There was no significant relationship between age groups and gender, stone localization, and number of SWL sessions. The overall SFR was 66.4%. Although the SFR was lower (61.4%) and the rate of multiple sessions (27.2%) was higher in ≥ 65 years group, there was no statistically significant difference between age groups regarding SFR, CIRF, need for additional sessions, and complication rates. Conclusions: Due to its similar clinical results, treatment of SWL should not be ignored as a treatment option in the geriatric patient group with kidney stones.


Morgan MS, Pearle MS. Medical management of renal stones. BMJ 2016;352:i52. DOI: https://doi.org/10.1136/bmj.i52

Turk C, Petrik A, Sarica K, et al. EAU Guidelines on Interventional Treatment for Urolithiasis. Eur Urol 2016;69:475-482. DOI: https://doi.org/10.1016/j.eururo.2015.07.041

Assimos D, Krambeck A, Miller NL, et al. Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol 2016;196:1161-1169. DOI: https://doi.org/10.1016/j.juro.2016.05.091

Pradere B, Doizi S, Proietti S, Brachlow J, Traxer O. Evaluation of Guidelines for Surgical Management of Urolithiasis. J Urol 2018;199:1267-1271. DOI: https://doi.org/10.1016/j.juro.2017.11.111

Knoll T, Buchholz N, Wendt-Nordahl G. Extracorporeal shockwave lithotripsy vs. percutaneous nephrolithotomy vs. flexible ureterorenoscopy for lower-pole stones. Arab J Urol 2012;10:336-341. DOI: https://doi.org/10.1016/j.aju.2012.06.004

Gokce MI, Akinci A, Akpinar C, Sanci A, Solak VT, Suer E. Comparison of Efficacy of Shock Wave Lithotripsy in Different Age Groups. Journal of Urological Surgery 2017;4:66-70. DOI: https://doi.org/10.4274/jus.1414

Kocakgol H, Yilmaz AH, Yapanoglu T, et al. Efficacy and Predictive Factors of the Outcome of Extracorporeal Shock Wave Lithotripsy: A Review of One-thousand-nine-hundred-ninety-seven Patients. Journal of Urological Surgery 2019;6:207-212. DOI: https://doi.org/10.4274/jus.galenos.2019.2562

Abdel-Khalek M, Sheir KZ, Mokhtar AA, Eraky I, Kenawy M, Bazeed M. Prediction of success rate after extracorporeal shock-wave lithotripsy of renal stones--a multivariate analysis model. Scand J Urol Nephrol 2004;38:161-167. DOI: https://doi.org/10.1080/00365590310022626

Ichiyanagi O, Nagaoka A, Izumi T, Kawamura Y, Kato T. Age-related delay in urinary stone clearance in elderly patients with solitary proximal ureteral calculi treated by extracorporeal shock wave lithotripsy. Urolithiasis 2015;43:419-426. DOI: https://doi.org/10.1007/s00240-015-0783-3

Abe T, Akakura K, Kawaguchi M, et al. Outcomes of shockwave lithotripsy for upper urinary-tract stones: a large-scale study at a single institution. J Endourol 2005;19:768-773. DOI: https://doi.org/10.1089/end.2005.19.768

Kimura M, Sasagawa T. Significance of age on prognosis in patients treated by extracorporeal shock wave lithotripsy. Nihon Hinyokika Gakkai Zasshi 2008;99:571-577.

Chen YZ, Lin WR, Lee CC, et al. Comparison of safety and outcomes of shock wave lithotripsy between elderly and non-elderly patients. Clin Interv Aging 2017;12:667-672. DOI: https://doi.org/10.2147/CIA.S134750

Philippou P, Lamrani D, Moraitis K, Wazait H, Masood J, Buchholz N. Shock-wave lithotripsy in the elderly: Safety, efficacy and special considerations. Arab J Urol 2011;9:29-33. DOI: https://doi.org/10.1016/j.aju.2011.03.009

Sighinolfi MC, Micali S, Grande M, Mofferdin A, De Stefani S, Bianchi G. Extracorporeal shock wave lithotripsy in an elderly population: how to prevent complications and make the treatment safe and effective. J Endourol 2008;22:2223-2226. DOI: https://doi.org/10.1089/end.2008.9704

Ng CF, Wong A, Tolley D. Is extracorporeal shock wave lithotripsy the preferred treatment option for elderly patients with urinary stone? A multivariate analysis of the effect of patient age on treatment outcome. BJU Int 2007;100:392-395. DOI: https://doi.org/10.1111/j.1464-410X.2007.06909.x

Polat F, Yesil S, Ak E, et al. Safety of ESWL in elderly: evaluation of independent predictors and comorbidity on stone-free rate and complications. Geriatr Gerontol Int 2012;12:413-417. DOI: https://doi.org/10.1111/j.1447-0594.2011.00781.x

Ozer, C., & Tekin, M. I. (2020). Clinical results of shock wave lithotripsy treatment in elderly patients with kidney stones: Results of 1433 patients. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.350

Downloads

Download data is not yet available.

Citations