Impact of COVID-19 on Ureteroscopy Management of Urolithiasis: Retrospective Comparative Study Before and After Pandemic

The COVID-19 pandemic disrupted healthcare delivery worldwide, potentially impacting the management of urolithiasis. This study aimed to evaluate changes in referral patterns, perioperative care, and surgical outcomes among patients undergoing ureteroscopic treatment for upper ureteral stones at a Japanese institution. A retrospective cohort of 467 patients who underwent ureteroscopic lithotripsy or retrograde intrarenal surgery between March 2018 and May 2022 was analyzed. The patients were divided into pre-pandemic (March 2018–March 2020, n = 244) and post-pandemic (April 2020–May 2022, n = 223) groups. Clinical characteristics and outcomes were compared. Baseline demographics were similar. After the pandemic onset, preoperative ureteral stenting increased (30.3% vs. 42.6%, p = 0.006), while surgical waiting times (36 days vs. 28 days, p = 0.005) and operative durations (77 min vs. 67 min, p = 0.018) decreased. Referral sources shifted (p = 0.045), with fewer primary care referrals and more from emergency or higher-level hospitals. Stone-free rates (65.6% vs. 58.7%, p = 0.128) and postoperative complication rates were comparable. Despite systemic constraints during the pandemic, timely adaptations in scheduling and perioperative management allowed for the continued delivery of safe and effective ureteroscopic treatment. These findings emphasize the importance of flexible clinical strategies during healthcare crises.