Mazzon G. et al., 2024: COVID-19 outbreak impact on urolithiasis treatments: A multicenter retrospective study across 9 urological centers in Italy.

Giorgio Mazzon 1, Stefania Ferretti 2, Emanuele Serafin 3, Francesco Claps 4, Pietro Acquati 5, Davide Brusa 3, Federico Germinale 6, Giuseppe Celentano 7, Andrea Pescuma 8, Andrea Vismara Fugini 9, Davide Campobasso 2, Umberto Maestroni 2, Giovanni Costa 1, Tonino Morena 9, Flavia Di Marco 4, Andrea Baudo 5, Massimiliano Creta 7, Nicola Pavan 10, Marco Ticonosco 8, Angelo Peroni 9, Devis Collura 6, Maria Angela Cerruto 3, Alessandro Antonelli 3, Luca Carmignani 5, Salvatore Micali 8, Carlo Trombetta 4, Giovanni Muto 6, Antonio Celia 1
1Department of Urology, AULSS7 Pedemontana, San Bassiano Hospital, Bassano del Grappa, Italy.
2Department of Urology, University Hospital of Pama, Parma, Italy.
3Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
4Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
5Department of Urology, IRCCS Policlinico San Donato, Milan, Italy.
6Department of Urology, Humanitas Gradenigo Hospital, Turin, Italy.
7Department of Neurosciences, Reproductive and Oral Sciences, University of Naples Federico II, Naples, Italy.
8Urology Department, University of Modena & Reggio Emilia, Modena, Italy.
9Department of Urology, Poliambulanza Foundation Hospital, Brescia, Italy.
10Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.

Abstract

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.

Curr Urol. 2024 Dec;18(4):301-306. doi: 10.1097/CU9.0000000000000246. Epub 2024 Apr 13. PMID: 40256306; PMCID: PMC12004962