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

Abstract. 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.