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%Cl,1.34-9.49),and a visual analog scale score of 4 or less(p=0.018;OR,1.97;95%Cl,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.