Volume 14, Supplement 1
Original Article / Published: April 2026
DOI: https://www.doi.org/10.57045/jemis/1410426.pp18-19
K.Hristov, O. Gatsev, V. Todorova, K. Petkova, I. Saltirov
Clinic of Urology, Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria
Abstract
Introduction: With the continuous increase in life expectancy, the proportion of elderly patients worldwide is steadily rising. This trend has led to a greater demand for minimally invasive treatment options. In parallel, technological advancements have broadened the application of retrograde intrarenal surgery (RIRS) in the treatment of nephrolithiasis.
Objective: The aim of this study is to evaluate and compare the efficacy and safety of RIRS in patients aged ≥65 years versus those younger than 65 years.
Matherials and methods: A retrospective analysis was conducted on 240 patients who underwent RIRS for renal stones between January 2023 and December 2025. Of these, 206 patients were younger than 65 years (group I), while 34 patients were aged ≥65 years (group II). Preoperative characteristics, stone-free rates, and intra- and postoperative complication rates were compared between the two groups.
Results: Preoperative characteristics were comparable, except for higher rates of anticoagulation therapy (52.9% vs 6.3%; p<0.001) and renal insufficiency (14.7% vs 8.3%; p=0.022) in group II. Most patients in group I were classified as ASA score I (65.5%), whereas the majority of patients in group II had an ASA score III (52.9%; p<0.001). Hypertension was the most common comorbidity in group I (19.9%), while 63.1% of patients had no comorbidities. In contrast, 26.5% of patients in group II presented with both diabetes and hypertension, and only 5.9% had no comorbidities (p<0.001). Regarding comorbidity burden, 47.6% of patients in group I had a Charlson Comorbidity Index (CCI) of 0, whereas 35.9% had CCI >2. In group II, only 8.8% had CCI=0, while 88.2% had CCI >2 (p<0.001). The stone-free rate after a single procedure was 90.8% in group I and 85.3% in group II (p=0.032). No statistically significant differences were observed between the groups in terms of mean operative time, complication type and severity, or length of hospital stay.
Conclusion: The results of this study demon- strate that RIRS represents a safe and effective modality for the management of renal stones in elderly patients (≥65 years). Age itself was not associated with an increased risk of postoperative complications.
Keywords:
RIRS, age, urolithiasis, efficacy, complications
How to cite this article:
K.Hristov, O. Gatsev, V. Todorova, K. Petkova, I. Saltirov Impact of patient age on perioperative outcomes of retrograde intrarenal surgery. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2026; 14(1): 18-19
Corresponding author:
Dr. Konstantin Hristov
Clinic of Urology
Military Medical Academy of Sofia
Department of Urology and nephrology, Clinic of Urology
3 “Georgi Sofiiski” blvd., Sofia 1606
Email: konstantin.hristovv@gmail.com