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Purpose <p>To evaluate the stone event-free survival following ureteroscopic lithotripsy (URSL) in bedridden elderly patients, including octogenarians and to identify the specific risk factors for recurrent stone events in this population.</p> Methods <p>We retrospectively analyzed the data of bedridden patients who underwent URSL for urolithiasis between January 2012 and June 2022 at our institution. The primary outcome of this study was ipsilateral stone event-free survival.</p> Results <p>The study analyzed 203 patients including 150 female (73.9%), with a median age of 81 years. During a median follow-up period of 29 months, 53 patients (26.1%) experienced ipsilateral recurrence of stone-related events and 12 patients (5.9%) experienced contralateral stone-related events, respectively. Seventy-seven patients (37.9%) died during the study period, with a median overall survival (OS) of 67 months. The estimated 2-year and 5-year ipsilateral stone event-free survival rates were 73.5% and 62.0%, respectively. The estimated 2-year any stone event-free survival and OS rates were 71.1% and 73.4%, respectively. The presence of struvite/carbonate apatite stone was independently associated with stone recurrence as a bedridden patient–specific risk factor.</p> Conclusion <p>Considering the adverse conditions specific to bedridden patients, URSL for urolithiasis is an acceptable procedure even with a high rate of stone recurrence. The identified risk factor may help guide treatment decisions for these high-risk patients.</p>

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Aggressive stone removal in octogenarian bedridden elderly patients: analysis of safety and impact on the reduction of recurrent stone-related events

  • 期刊论文

  • 发表日期：

    2026年1月17日

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  • Shigeki Koterazawa,
  • Toshifumi Takahashi,
  • Takeru Fujimoto,
  • Koji Yoshimura,
  • Masaaki Imamura

摘要

Purpose

To evaluate the stone event-free survival following ureteroscopic lithotripsy (URSL) in bedridden elderly patients, including octogenarians and to identify the specific risk factors for recurrent stone events in this population.

Methods

We retrospectively analyzed the data of bedridden patients who underwent URSL for urolithiasis between January 2012 and June 2022 at our institution. The primary outcome of this study was ipsilateral stone event-free survival.

Results

The study analyzed 203 patients including 150 female (73.9%), with a median age of 81 years. During a median follow-up period of 29 months, 53 patients (26.1%) experienced ipsilateral recurrence of stone-related events and 12 patients (5.9%) experienced contralateral stone-related events, respectively. Seventy-seven patients (37.9%) died during the study period, with a median overall survival (OS) of 67 months. The estimated 2-year and 5-year ipsilateral stone event-free survival rates were 73.5% and 62.0%, respectively. The estimated 2-year any stone event-free survival and OS rates were 71.1% and 73.4%, respectively. The presence of struvite/carbonate apatite stone was independently associated with stone recurrence as a bedridden patient–specific risk factor.

Conclusion

Considering the adverse conditions specific to bedridden patients, URSL for urolithiasis is an acceptable procedure even with a high rate of stone recurrence. The identified risk factor may help guide treatment decisions for these high-risk patients.