Has the COVID-19 pandemic affected ureteral stone management in pregnant women? A retrospective single-center study.

Autor:	Haghpanah A; Endourology Ward, Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran.; Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Kamran H; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran., Irani D; Endourology Ward, Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran., Kohansal E; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran., Rahmanian M; Medical School, MPH Department, Shiraz University of Medical Sciences, Shiraz, Iran., Defidio L; Clinica Nuova Claudia, Rome, Italy., Dehghani A; Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Jahanabadi Z; Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran., Askarpour MR; Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran.
Jazyk:	angličtina
Zdroj:	Urologia [Urologia] 2024 Aug; Vol. 91 (3), pp. 543-549. Date of Electronic Publication: 2023 Dec 24.
DOI:	10.1177/03915603231216154
Abstrakt:	Introduction: This study aimed to evaluate the effect of coronavirus disease (COVID-19) on the patients' referral in the pregnant population and also investigate each treatment approach's advantages and disadvantages for acute renal colic in pregnancy. Methods: In this retrospective study, we included all pregnant women with ureteral stones referred to a referral center between January 2019 and March 2021. Results: Among 53 pregnant women, 18 (33.9%) were on conservative therapy, which passed the stone without any complications. Double J stent or nephrostomy tube insertion was done for 24 patients (45.2%). Seventeen of these patients (70.8%) presented post-surgical complications, including hematuria (29.2%), pyelonephritis (20.8%), and lower urinary tract symptoms (20.8%). Transurethral lithotripsy (TUL) was done in 11 patients (20.7%). Only one of these patients developed hematuria following TUL. Thus, in our population study, double J stent or nephrostomy insertion was associated with a higher chance of postoperative complications than TUL ( p -value = 0.001). Thirty-six patients were referred within 13 months before the entry of COVID-19, while 17 were referred during a similar approximate duration after the COVID-19 entry into the country. Only the initial presentation had a significant difference between these two periods ( p -value = 0.034). Conclusions: When conservative treatment fails, we recommend TUL as the second-line treatment over temporary procedures, such as double J stent or nephrostomy insertion. Of note, in a group of patients with an emergent clinical setting, including active infection, deteriorating renal function, signs of preterm labor, solitary kidney, etc., double J or nephrostomy tube insertion remains the preferred management method for its fast resolution of obstruction and infection. Besides, a decrease in visits with an increase in complicated cases after COVID-19 was observed, maybe due to a delay in referring. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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