Population ageing is changing everyday urological practice. The number of older adults is increasing, and urology already treats a patient population that is, on average, older than the general population. Consequently, older adults with urolithiasis represent a core part of contemporary endourological practice. Given this, a focused review of the available evidence is valuable to inform clinical practice.
A peak in stone disease can occur in older adults who may also be less likely to present with the classical features of renal colic. As such, delayed or missed diagnosis may carry greater clinical consequences. Although the literature remains relatively limited, ureteroscopy, shock wave lithotripsy, and percutaneous nephrolithotomy remain feasible options in appropriately selected older adults. In this group in particular, broader health associations merit consideration, as the presence of urolithiasis in older adults may reflect overall health status in later life.
The burden of urolithiasis in older adults is increasing and now represents a routine component of everyday clinical practice. Clinical presentation may differ from that seen in younger "index" patients, and complications may have a greater impact on recovery and function. Management should therefore be individualized, taking into account comorbidity, frailty, functional status, and the patient's own priorities.
Current opinion in urology. 2026 Apr 30 [Epub ahead of print]
Ali Talyshinkii, Rifat Burak Ergül, Bhaskar K Somani, Patrick Juliebø-Jones
Genome Clinic, Astana, Kazakhstan., Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye., Department of Urology, University Hospitals Southampton, NHS Trust, Southampton, UK., Department of Urology, Haukeland University Hospital.