Changes in Ureteral Stone Treatment During COVID-19: A Single-Center Emergency Department Study

Adrian Militaru,1,2 Catalin Andrei Bulai,1,2 Cosmin Victor Ene,1,2 Razvan Ionut Popescu,1,3 Cristian Mares,1,2 Stefan Marian Balacescu,1,2 Razvan Dragos Multescu,1,2 Dragos Adrian Georgescu,1,2 Petrisor Aurelian Geavlete,1,2 Bogdan Florin Geavlete1,2 1Department of Urology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania; 2Department of Urology, “Saint John” Clinical Emergency Hospital, Bucharest, Romania; 3Department of Urology, “Prof. Dr. Th. Burghele” Clinical Hospital, Bucharest, RomaniaCorrespondence: Catalin Andrei Bulai, Department of Urology, “Saint John” Clinical Emergency Hospital, 13 Vitan-Barzesti str, Bucharest, 042122, Romania, Tel +40749184205, Email [email protected]: We evaluated the hospitalization rate, length of stay, and management of patients with ureteric lithiasis admitted under emergency conditions at a single institution during the COVID-19 pandemic.Patients and Methods: A retrospective study was conducted on 219 patients with ureteral lithiasis, divided into pre-COVID-19 (1.10.2019– 29.02.2020) and COVID-19 groups (1.10.2020– 29.02.2021). The study examined patient and stone characteristics, hospitalization duration, surgical interventions, creatinine levels, and associated urinary tract infections. It also evaluated the complications related to delayed treatment during the pandemic.Results: The study found a 73.41% reduction in admissions for obstructive ureteral lithiasis during the COVID-19 pandemic compared to the pre-pandemic period. Notable differences were observed in age (61.5 vs 46 years, p=0.000), gender (p=0.046), stone laterality (p=0.024), location (p=0.002), serum creatinine levels (1.59 vs 1.09 mg/dL, p=0.000), and urine cultures (45.65% vs 23.12%, p=0.002). During the pandemic period, the rate of primary stone extraction procedures decreased (32.6% vs 59%, p< 0.001), while operative time (52.89 vs 39.84 minutes, p< 0.001) and hospital stay significantly increased (13.09 vs 3.76 days, p< 0.001).Conclusion: The pandemic resulted in fewer hospitalizations for ureteral lithiasis and an increase in complications, likely due to reduced access to medical care and a greater tendency for upper urinary tract drainage.Keywords: COVID-19, urolithiasis, ureteroscopy, double J stent, ureteral stone, percutaneous nephrostomy