Ureteroscopy in the elderly: safety and functional results.

PURPOSE: To evaluate the effectiveness and safety of ureteroscopy (URS) for urinary stones treatment in patients ≥ 80 years of age. METHODS: From 2012 to 2021, 96 patients ≥ 80 years underwent URS for urinary stone disease. Patients' demographics and surgical outcomes were examined. RESULTS: The median length of follow-up was 25 months. Median age was 84 years. Half of the patients (53%) were ASA score 3 and 16% ASA 4. Mean stone diameter (SD) was 10.6 mm, and mean procedure time was 78 min. Eighty-three patients underwent follow-up imaging (ultrasonography or computed tomography) with a median time of 31 days. Stone-free rate was 73.9%. Twenty patients (20.7%) experienced a minor complication [Clavien-Dindo (CD) I-II] whereas five (5.7%) experienced a major complication (CD III-V). SD ≥ 10 mm predicted CD III-V complications (OR 1.25, 95% CI 1.01-1.55, p = 0.03). Urinary drainage prior the procedure with double J stent, nephroureteral stent or percutaneous nephrostomy tube had no impact on patients' SFR [74.6% in the drained group versus 64.0% in the undrained group (p = 0.44)] nor on major complications (OR 4.68, 95% CI 0.25-87.77, p = 0.30). CONCLUSION: In elderly patients, URS for treatment of renal and ureteral stones is a relatively efficient and safe procedure. The risk of major complications is low, and the only associated risk factor found was SD ≥ 10 mm. Urinary drainage prior the procedure did not affect patients' outcomes.

Obstruction of the ureter by neurofibroma of the urinary bladder treated endoscopically.

We present a case of a 23-year-old male with NF-1 diagnosed with bladder neurofibroma at childhood with regular ultrasound (US) follow-up since then, who presented with an obstructed left kidney. A detailed evaluation including blood tests and advanced imaging revealed left hydroureteronephrosis associated with a large bladder mass. The patient underwent cystoscopy and resection of the left ureteral orifice that was covered by the mass, and an indwelling ureteral stent was left in place. A follow-up US was performed one month after stent removal showing resolution of the hydronephrosis.