Evaluation of endoscopic ureteral stone treatments in the period of decreasing severity of COVID-19 pandemic

M. Serdar Buğday, B. Selçuk Çakmak, R. Çiçek

Department of Urology, Malatya Turgut Ozal University Training and Research Hospital, Malatya, Turkey. dr.msbugday@gmail.com

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• Urology

OBJECTIVE: During the COVID-19 pandemic, people’s admissions to the hospital for their current illness were delayed. We aimed to reveal how this situation has affected the endoscopic treatment of ureteral stones.

PATIENTS AND METHODS: Patients who were treated for 59 endoscopic ureteral stones in the pre-pandemic period between September 2019 and December 2019, and patients who were treated for 60 endoscopic ureteral stones between January 2022 and April 2022, when the effectiveness of the COVID-19 pandemic decreased, were evaluated in two groups. Pre-pandemic patients were classified as group 1, and patients treated during the period when the effectiveness of the pandemic decreased as group 2. The patients’ ages, preoperative laboratory examinations and radiological findings, localization and size of the stones in the ureter, time until the operation, duration of the operation, length of hospital stay, preoperative ESWL history, complication rates according to the Modified Clavien classification were evaluated. The problems observed in the ureter during the operation were examined separately as edema, polyp formation in the ureter, distal ureteral stenosis, and adhesion of the stone to the mucosa.

RESULTS: In group 1, 9 patients were female and 50 were male, with a mean age of 42.19 ± 14.06 years; in group 2, 17 patients were female and 43 were male, with a mean age of 45.23 ± 12.20 years. The stone size was found to be higher in group 2. Group 1 had more patients who did not develop complications in the Modified Clavien classification, and the proportion of group 2 patients in the grade I-II-IIIA-IIIB classification was higher. Considering the waiting time before hospitalization, it was determined that the rate of group 2 patients was higher in those with a waiting period of 31-60 days (33.9-48.3%) and ≥60 days (10.2-21.7%). Except for the development of ureteral polyps, all other problems rate were found to be higher in group 2 patients compared to group 1.

CONCLUSIONS: During the COVID-19 pandemic, there was a delay in the treatment of ureteral stones in patients. In the next period, as a result of this delay, negative effects on the ureteral mucosa were detected and, accordingly, an increase in the complication rates of the operation was observed.

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