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COVID-19 outbreak impact on urolithiasis treatments: A multicenter retrospective study across 9 urological centers in
Giorgio Mazzon1, Stefania Ferretti2, Emanuele Serafin3
1Department of Urology, AULSS7 Pedemontana, San Bassiano Hospital, Bassano del Grappa, Italy.
Insights
The COVID-19 pandemic significantly reduced upper urinary tract stone treatments, leading to longer waiting times for procedures like extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. This disruption may increase patient risk and discomfort.
Area of Science:
- Urology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic presented significant challenges to healthcare systems globally.
- Management of upper urinary tract stones was notably affected by pandemic-related disruptions.
Purpose of the Study:
- To compare the impact of the COVID-19 pandemic on endourological services for upper urinary tract stones.
- To analyze changes in treatment numbers, case urgency, and operational complexity before and during the pandemic.
Main Methods:
- A retrospective study was conducted across 9 Italian centers.
- Data from a 12-month period before COVID-19 (March 2019-February 2020) were compared to a 12-month COVID-19 period (March 2020-February 2021).
- Key outcome measures included the total number of procedures, rates of urgent versus elective cases, and waiting times.
Main Results:
- A 15.35% overall reduction in procedures was observed during the COVID-19 period.
- Elective cases decreased by 21.09%, affecting all treatment modalities including extracorporeal shock wave lithotripsy (-29.37%) and percutaneous nephrolithotomy (-26.47%).
- Waiting times for elective procedures significantly increased, with ureteral stone waiting times rising from 61.44 to 86.56 days and renal stone waiting times for percutaneous nephrolithotomy increasing from 96.9 to 1103.9 days.
Conclusions:
- The COVID-19 pandemic caused significant disruption to endourological services for upper urinary tract stones.
- Prolonged treatment delays during the pandemic may elevate the risk of stone-related complications and patient discomfort.
Background:
The coronavirus disease (COVID-19) pandemic has posed challenges to the global health care community, affecting the management of upper urinary tract stones.
Materials And Methods:
This retrospective study involved 9 Italian centers. We compared the 12-month period prior to COVID-19 (March 1, 2019, to February 28, 2020; Period A) with the COVID-19 period (March 1, 2020, to February 28, 2021, Period B). This study aimed to compare outcomes during Periods A and B, specifically focusing on the overall number of treatments, rate of urgent/elective cases, and operational complexity.
Results:
A total of 4018 procedures were collected, comprising 2176 procedures during Period A and 1842 during Period B, indicating a loss of 15.35% (p < 0.001). In the elective cases, 1622 procedures were conducted in Period A, compared with 1280 in Period B, representing a 21.09% reduction in cases (p = 0.001). All types of stone treatments were affected: extracorporeal shock wave lithotripsy (-29.37%, p = 0.001), percutaneous nephrolithotomy (-26.47%, p = 0.008), retrograde surgeries for renal stones (-10.63%, p = 0.008), and semirigid ureterolithotripsy (-24.86%, p = 0.008). Waiting lists experienced significant delays during Period B. The waiting time (WT) for elective procedures increased during Period B (p < 0.001). For ureteral stones, the mean WT in Period A was 61.44 days compared with 86.56 days in Period B (p = 0.008). The WT for renal stones increased from 64.96 days in Period A to 85.66 days in Period B for retrograde intrarenal surgery (p = 0.008) and from 96.9 days to 1103.9 days (p = 0.035) for percutaneous nephrolithotomy procedures.
Conclusions:
Our study demonstrates that COVID-19 significantly disrupted endourological services across the country. Our data underline how patients received treatment over a prolonged period, potentially increasing the risk of stone-related complications and patient discomfort.
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