Changes That Have Occurred in the Surgical Treatment Preference for Non-emergent Kidney Stones During the COVID-19 Pandemic: Six Months of Clinical Experience in A Tertiary Referral Centre

Objective: Owing to the outbreak of the coronavirus disease-2019 (COVID-19), treatment approaches are reshapened because of the excessive load on the health system. This study aimed to investigate the differences in our surgical approach to kidney stone cases between the COVID-19 period and pre-COVID-19 period. Materials and Methods: Patients who underwent retrograde intrarenal surgery (RIRS) or percutaneous nephrolithotripsy (PNL) for kidney stones in our clinic between March 11, 2020, and September 11, 2020, and those in the same period 1 year ago were included in the study. Demographic information, laboratory data, stone characteristics, treatment choices and results were evaluated comparatively. Results: A total of 39 patients in the COVID-19 period (group 1) and 93 patients in the pre- COVID-19 period (group 2) underwent kidney stone surgery. While RIRS was performed to 32 of the patients in group 1, PNL was applied to seven of the patients in group 2. RIRS was performed to 70 patients in group 2, and PNL was applied to 23 of them. While the RIRS/PNL ratio was 4.5 in group 1, it was 3.04 in group 2. During the COVID-19 period, the number of patients who underwent PNL has decreased significantly. Conclusion: The number of elective surgery cases has significantly decreased during the COVID-19 pandemic. It is predicted that the incidence of organ loss will increase due to complications and delayed treatment. Moreover, interruption of the residents' surgical training secondary to the decreasing number of cases is one of the pandemic's critical drawbacks.

Automated summary

The number of kidney stone surgeries during the COVID-19 period decreased significantly, with more patients opting for retrograde intrarenal surgery. The pandemic led to a reduction in elective surgery cases, potentially increasing complications and delayed treatment, while also impacting resident surgical training due to fewer cases.