ESWL as a method for kidney decompression in treatment of ureteral calculi during the Covid-19 pandemic

Abstract

Introduction and objective: The application of ESWL in treatment of ureteral calculi is to achieve kidney desobstruction with minimal pain, aiming to reduce the need of analgesia and hospital stay. In times of Covid-19 pandemic by reducing the hospital stay, patients have less contacts and it is more safe for them from an epidemiological point of view. The objective of our study is to evaluate the efficacy and safety of ESWL as a method of kidney desobstruction caused of ureteral calculi during Covid-19 pandemic. Material and methods: A retrospectively collected database of 77 patients, who underwent ESWL for ureteral stones between February 2020 and January 2022 in the Clinic of Endourology and SWL, Military Medical Academy, Sofia, Bulgaria, was reviewed. Data on patients’ preoperative characteristics, stone-free rates, complications and auxiliary procedures were analyzed. Results: Patients’ mean age was 49.1±12.8 years and male-to-female ratio – 75.3%/24.7%. Mean stone length was 6.5±2 mm and mean stone width was 4.5±1.5 mm. Fifty-two (n=52, 67.5%) of the cases were with stones located in the proximal ureter, in the middle ureter (n=14, 18.2%) and in the distal ureter (n=11, 14.3%). Preoperative drainage with ureteral stent was completed in 13 cases (16.9%). Mean hospital stay was 1.28 days Mean number of SWL hits was 3527±692. Full stone disintegration was observed in 55 patients (71.4%) and partial disintegration was observed in 22 patients (28.6%). Eight (36.4%) of the patients with partial disintegration of the stone needed another ESWL, in 2 (9%) people was performed RIRS afterward and 8 cases (36.4%) required performing an URS at a later stage. Conclusions: The ESWL as a method of treatment in ureteral calculi has good success rate. With the short hospital stay, it is an appropriate method for times of Covid-19 pandemic. However in some cases, invasive endourological operations such as ureteroscopy could not be avoided in order to be achieved full kidney desobstruction. Key words: extracorporeal lithotripsy, ureteral stones, Covid 19