Effectiveness and safety of ureteroscopic holmium laser lithotripsy for upper urinary tract calculi in elderly patients

Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the '<65 group' (<65 years old, n = 108), the '65-74 group' (65-74 years old, n = 42), and the '≥75 group' (≥75 years old, n = 39). The patients' characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the ≥75 group had a significantly higher prevalence of hypertension compared to the <65 group. Compared to the <65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the ≥75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the ≥75 group were similar to those of the <65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.