How has the COVID-19 pandemic changed treatment preferences of patients with proximal ureteral stones?

BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic on patient decision making remains uncertain. This study aimed to investigate the effect of the pandemic on treatment preferences of patients with proximal ureteral stones.

MATERIALS AND METHODS: Retrospective data regarding treatment preferences of patients diagnosed with symptomatic proximal ureteral stones between July 2018 and November 2021 at a single center were analyzed. Data from 493 patients were analyzed according to 2 groups, including patients diagnosed during the COVID-19 pandemic and those diagnosed during an equivalent period of time before the pandemic.

RESULTS: Preference for conservative treatment increased during the COVID-19 pandemic ( p = 0.009). In patients who had previously undergone shock wave lithotripsy (SWL), the preference for SWL decreased and the preference for conservative treatment increased during the COVID-19 pandemic ( p = 0.042). Multiple logistic regression analysis revealed a significant correlation between a preference for conservative treatment during the pandemic and no prior spontaneous stone passage ( p = 0.003; odds ratio [OR], 2.48; 95% confidence interval [CI], 1.45-4.23), no hydronephrosis ( p = 0.035; OR, 3.57; 95% CI, 1.34-9.49), and a visual analog scale score of 4 or less ( p = 0.018; OR, 1.97; 95% CI, 1.15-3.38).

CONCLUSIONS: A significant increase in the preference for conservative treatment was observed among patients diagnosed during the pandemic, and patients with a history of SWL demonstrated a preference shift from SWL to conservative treatment.