{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:45:46Z","timestamp":1791776746515,"version":"4.3.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,11]]},"abstract":"\n Objectives<\/jats:title>\n To evaluate the association between operative time (OT) and postoperative complications after percutaneous nephrolithotomy (PCNL) in elderly patients, and to identify a clinically meaningful OT threshold for risk stratification.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n A retrospective international multicentre study was performed including patients aged \u226570\u2009years who underwent PCNL between January 2014 and February 2025 across 21 centres in 15 countries. Postoperative complications within 30\u2009days were analysed as overall, major, and infectious events. The optimal OT threshold was determined using receiver operating characteristic (ROC) analysis, whereas the association between OT and postoperative outcomes was evaluated using multivariable logistic regression and adjusted restricted cubic spline models.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 716 patients, 120 (16.8%) developed postoperative complications; 49 (6.8%) had major and 49 (6.8%) infectious complications. ROC analysis identified a common OT threshold around 95\u2009min. An OT \u226595\u2009min was independently associated with overall complications (odds ratio [OR] 3.37, 95% confidence interval [CI] 2.16\u20135.26), major complications (OR 2.63, 95% CI 1.35\u20135.10), and infectious complications (OR 3.79, 95% CI 1.90\u20137.57). The highest discriminative performance was observed for infectious complications (multivariable model area under the curve 0.77). Restricted cubic spline analysis confirmed significant non\u2010linear associations between OT and all outcomes, with a steeper increase in adjusted complication probability beyond approximately 90\u2013100\u2009min. Non\u2010papillary puncture was independently associated with all complication types, while positive preoperative urine culture predicted infectious complications.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In elderly patients undergoing PCNL, prolonged OT was independently associated with higher odds of overall, major, and infectious postoperative complications. The relationship was non\u2010linear, with a clinically relevant threshold around 95\u2009min, supporting OT as a practical intraoperative marker for risk stratification and procedural planning.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.70440","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T07:35:52Z","timestamp":1789976152000},"page":"915-926","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of operative time on complications after\n PCNL<\/scp>\n in the elderly (aged \u226570\u2009years): the Safety and Efficacy of Nephrolithotomy in Older patients undergoing PCNL (\n SENIOR<\/scp>\n \u2010\n PCNL)<\/scp>\n study"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-8196","authenticated-orcid":false,"given":"\u0141ukasz","family":"Nowak","sequence":"first","affiliation":[{"name":"Department of Minimally Invasive and Robotic Urology University Centre of Excellence in Urology, Wroclaw Medical University Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Krajewski","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Robotic Urology University Centre of Excellence in Urology, Wroclaw Medical University Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-6478","authenticated-orcid":false,"given":"Bhaskar","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Urology University Hospital Southampton NHS Foundation Trust Southampton UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Szyde\u0142ko","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Robotic Urology University Centre of Excellence in Urology, Wroclaw Medical University Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3740-7141","authenticated-orcid":false,"given":"Vineet","family":"Gauhar","sequence":"additional","affiliation":[{"name":"Department of Urology Ng Teng Fong General Hospital Singapore Singapore"},{"name":"Asian Institute of Nephrourology, AINU Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9956-1558","authenticated-orcid":false,"given":"Steffi Kar Kei","family":"Yuen","sequence":"additional","affiliation":[{"name":"S.H. Ho Urology Centre, Department of Surgery The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-0917","authenticated-orcid":false,"given":"Matthias","family":"Boeykens","sequence":"additional","affiliation":[{"name":"Department of Urology Ghent University Hospital Ghent Belgium"},{"name":"Department of Urology AZ Maria Middelares Ghent Belgium"},{"name":"Department of Urology AZ Delta Roeselare Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5801-5801","authenticated-orcid":false,"given":"Thomas","family":"Tailly","sequence":"additional","affiliation":[{"name":"Department of Urology Ghent University Hospital Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Mykoniatis","sequence":"additional","affiliation":[{"name":"First Department of Urology Aristotle University of Thessaloniki 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