Urinary stones are a common urologic condition known for causing severe flank pain. In older patients, kidney function is often reduced compared with younger individuals, and the elasticity of the ureter may also decline, making it more difficult for stones to pass naturally. In addition, aging is associated with a decrease in total body water, which can increase the likelihood of stone formation.
If urinary stones in older adults are left untreated, they may lead to declining kidney function. In severe cases, they can progress to kidney failure. For this reason, prompt treatment is important when a stone does not pass naturally.
For patients aged 65 and older, however, a more careful treatment approach is required. Older individuals frequently have underlying conditions such as diabetes or cardiovascular disease, which can increase the burden associated with surgical treatment. Fortunately, advances in medical technology have made it possible for elderly patients to receive urinary stone treatment more safely than in the past.
Treatment options for urinary stones include conservative management aimed at encouraging natural passage, extracorporeal shock wave lithotripsy (ESWL), and ureteroscopic stone removal.
When conservative treatment is unsuccessful, procedures such as shock wave lithotripsy or ureteroscopic removal may be recommended. In ureteroscopic stone removal, a small endoscope is inserted through the urinary tract into the ureter, allowing the physician to directly visualize and remove the stone. Because the procedure is performed without external incisions, the risk of bleeding is relatively low and recovery tends to be faster.
Urinary stone treatment is not necessarily limited by age. With the development of minimally invasive techniques using endoscopic equipment, many patients over the age of 65 can now receive treatment safely. Ureteroscopic procedures offer the advantage of removing stones quickly while preserving kidney function.
Nevertheless, careful evaluation is required for elderly patients. Those with underlying conditions such as diabetes, cardiovascular disease, or hypertension may need to review medications such as blood thinners with their physician before treatment. If kidney function is already impaired, treatment planning should focus on preventing further damage as early as possible. Because immune function may also be reduced in older individuals, measures to prevent infection are particularly important.
Even after successful treatment, preventing recurrence is essential in urinary stone disease. Patients are generally advised to drink approximately 2.5 to 3 liters of water per day to maintain adequate urine dilution. Reducing excessive sodium intake and limiting animal protein consumption can also help prevent stone formation. In addition, metabolic testing to analyze the composition of the stone can guide personalized dietary adjustments. Regular physical activity is also recommended to support overall urinary tract health.
Dr. Min Seung-gi of Goldman Urology Clinic’s Jamsil branch noted that patients aged 65 and older remain at risk of recurrence even after stone removal surgery. He emphasized the importance of lifestyle modification and regular medical checkups following treatment. With consistent follow-up and adherence to medical guidance, elderly patients can reduce the likelihood of recurrence and maintain a healthier quality of life.