Ureteric Stone Treatment Changed During the Pandemic, but Outcomes Did Not

Patients with ureteric stones in the United Kingdom were less likely to receive invasive management during the COVID-19 pandemic compared with before, but the treatment success rate did not change, according to data presented at the European Association of Urology 2022 annual congress.

During the pandemic, use of medical expulsive therapy and extracorporeal shockwave lithotripsy (ESWL) increased, whereas ureteroscopy and stent procedures decreased.

Investigators compared ureteric stone management during a 3-month period before the pandemic (March 23-June 22, 2019) with a 3-month period during the pandemic (3 months after the first COVID-19 case at each of 39 UK hospitals). The study included 3735 patients with computed tomography-proven ureteric stones: 1956 pre-pandemic and 1779 during the pandemic. The primary outcome was success of primary treatment, defined as no need for further treatment for a ureteric stone.

The groups did not differ significantly with respect to demographics or stone factors.

A significantly higher proportion of patients received medical expulsive therapy during the pandemic compared with the pre-pandemic period (25.4% vs 17.4%), first author Matthew Byrne, MBBS, of the University of Oxford in the UK, reported in an oral presentation. Patients treated for a ureteric stone during the pandemic were significantly less likely to be hospitalized (46.5% vs 54.0%) and had a significantly shorter hospital length of stay (mean 3.3 vs 4.1 days). During the pandemic, the proportion of ESWL and nephrostomy procedures increased by 11.4% and 3.4%, respectively, whereas the proportion of ureteroscopy and stent procedures decreased by 9.7% and 13.8%, respectively. Use of general anesthesia declined by 16%. All of these changes were significant, according to Dr Byrne.

Despite these changes in management, the treatment success rate for a ureteric stone in the pre-pandemic and pandemic groups did not differ significantly (73.8% vs 76.1%, respectively). The investigators defined treatment success as the absence of a need for further treatment.

Dr Byrne and colleagues found no significant difference in 30-day surgical complications, critical care admissions, and mortality, as well as 6-month readmissions, renal function, or need for further treatment, according to the investigators.

Reference

Byrne MHV, Georgiades F, Lovegrove CE, et al. Impact of COVID-19 on the management of ureteric stones in the UK: The COVID Stones study. Presented at: EAU 2022, July 1-4, 2022, Amsterdam, The Netherlands. Abstract A0249.

This article originally appeared on Renal and Urology News