Related Experiment Video
Updated: Aug 19, 2025
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
The effect of COVID-19 outbreak on urological procedures for urinary stones: data from three high-volumes centers in
Giorgio Mazzon1, Xin Zhang1, Xingguo Yang2
1Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Insights
The COVID-19 pandemic significantly reduced urinary stone treatments, especially percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS). While retrograde procedures recovered post-restriction, PCNL volumes remained low, indicating lasting impacts on urolithiasis care.
Area of Science:
- Urology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic disrupted healthcare services globally, with unclear effects on urinary stone treatment.
- China, as an early epicenter, provides a unique setting to study these impacts.
Purpose of the Study:
- To evaluate the impact of COVID-19 restrictions on surgical volumes and outcomes for upper urinary tract stones.
- To compare stone treatment trends before, during, and after pandemic-related restrictions.
Main Methods:
- Retrospective study across three tertiary referral centers in China.
- Analysis of surgical procedures for upper urinary tract stones over three periods: pre-restriction, during restriction, and post-restriction.
- Comparison of procedure volumes and stone-free rates (SFRs).
Main Results:
- Overall surgical cases decreased by 29.2% during restrictions and 7.9% after. Percutaneous nephrolithotomy (PCNL) volumes drastically reduced, with standard PCNLs falling by 95.2% and mini-PCNLs by 60.8%.
- Retrograde intrarenal surgery (RIRS) decreased by 54.8% during restrictions but increased by 11.4% in the subsequent period.
- Stone-free rates for RIRS and semi-rigid ureteroscopies showed some variation but no significant differences in complications or comorbidity scores were observed.
Conclusions:
- The COVID-19 pandemic led to a substantial decline in urinary stone surgical procedures, particularly PCNL.
- While some procedures like RIRS showed recovery, the overall impact on urolithiasis treatment volumes persisted.
- Healthcare systems need strategies to mitigate disruptions to essential surgical services during pandemics.
Abstract:
China has been the first country to be affected by the COVID-19 outbreak. The pandemic resulted in significant disruption of Health Care Services worldwide, and this effect on treatments for urinary stones is currently unclear. This is the first retrospective study involving three tertiary referral centers for urolithiasis across China. We evaluated surgical volumes and peri-operative outcomes of procedures delivered for upper urinary tract stones. We compared trimester prior to restrictions for COVID-19 (October 1st, 2019 to December 31st, 2019, period A), during restrictions (February 1st, 2020 to March 31st, 2020, period B), and afterword (April 1st, 2020 to June 31st, 2020, period C). A total of 2,543 procedures have been carried out. We observed a loss of 743 cases during period B (-29.2%) and 201 during period C (-7.9%). Percutaneous surgery showed the worst reduction, with 507 mini-PCNLs delivered in period A, 168 in period B (-60.8%), and 389 (-18.3%) in period C (p = 0.001). A worst trend was shown for standard PCNLs with 84 procedures carried out in period A, 5 in period B (-95.2%), and 9 (-89.2%) in period C (p = 0.001). Retrograde surgery also decreased, from 420 cases in period A to 190 cases in period B (-54.8%). An increment was however seen in period C when 468 cases have been carried out (+ 11.4%, p = 0.008). In term of SFRs, a difference was noticed for RIRSs, being 69.2%, 80.5%, and 69.3% during three periods (p = 0.045) and semirigid ureteroscopies (90.3%, 97.1%, and 84.8%, p = 0.013). Charlson's Comorbidity Score could not show any difference between groups as well as no differences in term of post-operative complications have been noticed.
More Related Videos
06:39Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
Published on: November 22, 2019
07:17Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
Published on: May 9, 2018
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:30Urinary Tract Calculi III: Medical Management
01:28Urinary Tract Calculi V: Nursing Management
01:27Urinary Tract Calculi IV: Nutrition Therapy and Prevention
01:28Urologic Endoscopic Procedure: Cystoscopic Examination