Efficacy and Safety of Holmium Laser Lithotripsy Under Local Anesthesia in the Treatment of Urethral Stones in Elderly Male Patients

Abstract

The elderly population has been increasing significantly in our century. In our study, it was aimed to analyze the treatment results of elderly male patients who underwent holmium laser lithotripsy (HLL) for urethral stones under local anesthesia. We evaluated a total of 31 male patients, aged ≥65 years, diagnosed with urethral stones and treated with HLL under local anesthesia. We noted the demographic data and visual pain scores (VAS) of the patients and the duration of the operation and hospital stay. Our analysis involved both the success rates of the surgical procedure and the complication rates according to the modified Clavien classification. In addition. we determined the patients’ preoperative clinical status using the Charlson comorbidity index (CCI). The mean age of the patients was 71.65 ± 8.19 years. Acute urinary retention was the most common complaint (45.2%). Their mean scores were 7.68 ± 2.53 according to CCI. The average operation time was 15.48 ± 5.22 min and the VAS was 2.03 ± 1.08. All patients were stone-free and there was a marked improvement in their symptoms None of them stayed in the hospital for more than one day. We did not observe any Grade 3 or higher complications. In light of the data obtained in our study, we concluded that HLL is an effective and reliable method to treat urethral stones under local anesthesia in elderly male patients.

Post-Operative All-Cause Mortality in Elderly Patients Undergoing Abdominal Emergency Surgery: Role of Charlson Comorbidity Index

“…In elderly patients, it is difficult to consider every single risk factor for negative outcome, especially in an emergency surgical care setting; for this reason, a general assessment including medical chronic conditions could be useful in the management of surgical patients [ 21 ]. In elderly subjects, comorbidity is a risk factor for in-hospital mortality [ 22 ] and CCI has been associated with development of nosocomial infections [ 23 ] and it has been used for evaluation preoperative clinical status of older adults who need laser lithotripsy [ 24 ]. Comorbidity scores are usually easy to calculate and summarise in a unique number the burden of comorbidities predicting short and long-term prognosis, independently from age.…”