Ureteroscopy for stone disease in the elderly (≥ 80 years): Outcomes of a multicentre study from YAU and EAU endourology groups

Tzelves L. Somani B. Yuen S.K.K. Gauhar V. De S. Pietropaolo A. Castellani D. Ragoori D. Emiliani E. Ventimiglia E. Tsaturyan A. Sener T.E. Frascheri M.F. Sierra A. Esperto F. Nowak Ł. De Coninck V. Mykoniatis I. Olivero A. Ergül R.B. Martinez B.B. Bautista-Perez-Gavilan A. Patel S. Villalba E. Seyidov Q. Vanthoor J. Tsiakaras S. Triantafyllou P. Pischetola A. Villa L. Arena P. Ulvik Ø. Æsøy M.S. Gjengstø P. Talyshinskii A. Beisland C. Juliebø-Jones P.
December 2025 Springer Science and Business Media Deutschland GmbH

Urolithiasis
2025 #53 Issue 1

The objective of this study was to perform a multi-centre and global study evaluating the clinical outcomes and complications associated with of URS for stone disease in patients aged 80 years and above. Retrospective analysis was conducted on patients aged ≥ 80 years who underwent URS for stone disease between January 2014 and December 2024, across 20 centres in 14 countries. A total of 679 patients aged ≥ 80 years underwent ureteroscopy (URS), with a median age of 83 years (IQR 81–86) and a male-to-female ratio of 1.2:1. Most patients were ASA grade 2 (52%) and presented electively (95%), with general anaesthesia used in 77% of cases. The median cumulative stone size was 11 mm (IQR 7–15), and 56% had a single stone. The overall stone-free rate (SFR) was 70% for zero fragments, increasing to 84% when including fragments ≤ 2 mm, and 90% when including fragments ≤ 4 mm. The overall 30-day complication rate was 16%, with major complications (Clavien-Dindo grade ≥ 3) in 2.8% of patients. The most common complication was urinary tract infection (9.4%). One procedure-related death (0.1%) was recorded. Multivariable analysis identified ASA score ≥ 3 (OR 1.60), operative time > 60 min (OR 1.73), and emergency surgery (OR 2.96) as independent predictors of complications. Ureteroscopy can be performed in patients aged 80 years and above with a low risk of major complications and acceptable stone clearance rates. Avoiding both emergency surgery and prolonged operative times can help reduce the morbidity profile.

Complications , Elderly , Mortality , Older , Ureteroscopy , Urolithiasis

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2nd Department of Urology, Sismanoglio Hospital, National and Kapodistrian University of Athens, Athens, Greece
EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group, Arnhem, Netherlands
EAU Endourology Endourology Section, Arnhem, Netherlands
Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, United Kingdom
Department of Surgery, SH Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore
Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, India
Department of Urology, Cleveland Clinic Glickman Urological & Kidney Institute, Cleveland, OH, United States
Urology Unit, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
Department of Urology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain
Department of Urology, NYU Langone Health, NYU Grossman School of Medicine, New York, United States
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
Department of Urology, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
Department of Urology, Erebouni Medical Center, Yerevan, 0087, Armenia
Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
Department of Urology, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina
Department of Urology, Hospital Clínic de Barcelona - University of Barcelona, Barcelona, Spain
Department of Urology, Campus Bio-Medico University, Rome, Italy
Department of Minimally Invasive and Robotic Urology, University Center of Excellence in Urology, Wroclaw Medical University, Wroclaw, Poland
Department of Urology, AZ Klina, Brasschaat, Belgium
Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, 541 24, Greece
Department of Urology, ASST Grande Ospedale, Niguarda, Metropolitano, Milan, 20162, Italy
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Department of Urology, University Hospital Del Vinalopó, Alicante, Spain
Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
Department of Clinical Medicine, University of Bergen, Bergen, Norway
Department of Urology, Haukeland University Hospital, Bergen, Norway
Astana Medical University, Astana, Kazakhstan

2nd Department of Urology
EAU Young Academic Urologists (YAU) Urolithiasis and Endourology Working Group
EAU Endourology Endourology Section
Department of Urology
Department of Surgery
Department of Urology
Department of Urology
Department of Urology
Urology Unit
Department of Urology
Department of Urology
Department of Surgical Sciences
Department of Urology
Department of Urology
Department of Urology
Department of Urology
Department of Urology
Department of Urology
Department of Minimally Invasive and Robotic Urology
Department of Urology
Department of Urology
Department of Urology
Department of Urology
Department of Urology
Division of Experimental Oncology/Unit of Urology
Department of Clinical Medicine
Department of Urology
Astana Medical University

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