Introduction. In the context of the global demographic trend of an aging population, effective methods for treating nephrolithiasis become particularly relevant. Percutaneous nephrolithotomy (PNL) remains one of the leading surgical interventions. With the emergence of new technologies in nephrolithiasis surgery, opportunities arise for the effective combination of various endourological methods, enhancing the efficiency and safety of operations.

Study оbjective. The study aims to conduct a comparative analysis of the efficacy and safety of standard PNL with nephrostomy tube placement and tubeless PNL in patients over 60 years of age.

Materials and methods. Data analysis included 50 patients who underwent PNL from January 2020 to November 2023. Patients were divided into two groups: standard PNL (Group 1) and tubeless PNL (Group 2). Evaluation was based on parameters such as Stone Free Rate (SFR), operation time, postoperative complications, blood transfusion requirements, and hospital stay duration.

Results. Tubeless PNL was associated with a shorter hospitalization period and postoperative stay compared to PNL with a nephrostomy tube.

Conclusions. Tubeless PNL is an effective and less invasive method for treating nephrolithiasis in elderly patients. Choosing this technique may reduce the risk of complications, ensuring more favorable outcomes.