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Open Access 01-12-2020 | Triage | Review

Urolithiasis treatment options during COVID-19 pandemic: review of current recommendations and triage systems

Authors: Ali Abdel Raheem, Ibrahim Alowidah, Mohamed Soliman, Mefarrih Haresy, Ali Almozeni, Sultan Althagafi, Mohamed Almousa, Mohamed Alturki

Published in: African Journal of Urology | Issue 1/2020

Abstract

Background

COVID-19 pandemic has overwhelmed healthcare systems and limited access to surgical care. Urolithiasis can lead to emergencies and affect renal function during long-term follow-up. Therefore, timely and appropriate treatment is essential.

Main text

This is a non-systematic review of the recently published recommendations regarding urolithiasis treatment options during COVID-19. Fourteen publications were the basis of our review. Regarding anesthesia methods, the optimal methods are still unknown. During COVID-19, most of the endo-urologists changed their routine clinical practice and elective surgical treatment approaches. Despite decreasing number of emergency visits and admissions for stone disease, patients tend to have leukocytosis, higher creatinine levels, increased grade 3 and 4 hydronephrosis, and higher incidence of complications compared to non-COVID-19 time. Several alarming indications if present, intervention should be performed within 24 h to prevent irreversible kidney damage, disease progression, or even death. Some endo-urologists prefer definitive stone treatment over temporarily drainage to reduce the number of emergency room visits and hospital admissions, except if infection is present or staged treatment is planned. Several clinical scenarios of non-emergency and non-urgent urinary stones are present; thus, endo-urologists should appropriately weigh patient’s risk and surgery benefit to decide to the proper intervention time. If risks outweighed benefits to the patient, postpone the surgery. Renal colic should be managed with medical expulsive therapy and proper pain control with close follow-up just in case it becomes an emergency. Indwelling JJ stent removal or exchange is a matter of debate; some endo-urologists recommend removing, while others recommend postponing.

Conclusion

Treatment options for urinary stones have markedly changed during COVID-19 pandemic. The optimal anesthesia methods are still unknown. Emergency intervention is a must if any alarming indications exist. Emergency cases tend to have higher incidence of complications compared to non-COVID-19 time. For non-emergency and non-urgent urolithiasis, endo-urologists should make judicious treatment decision to prioritize urolithiasis treatment, and they should weigh benefits and risks before surgery.

World Health Organization (2020) Coronavirus disease (COVID-19) pandemic. https://www.who.int/ [Google Scholar]. Accessed 19 Oct 2020

Terry K (2020) Hospital volumes slashed by more than half during pandemic. Medscape Medical News. https://www.medscape.com/viewarticle/930345. Accessed 19 Oct 2020

Naspro R, Da Pozzo LF (2020) Urology in the time of corona. Nat Rev Urol. https://doi.org/10.1038/s41585-020-0312-1CrossRefPubMedPubMedCentral

Flammia S, Salciccia S, Tufano A, Busetto GM, Ricciuti GP, Sciarra A (2020) How urinary stone emergencies changed in the time of COVID-19? Urolithiasis 28:1–3. https://doi.org/10.1007/s00240-020-01198-3CrossRef

Tefik T, Guven S, Villa L, Gokce MI, Kallidonis P, Petkova K et al (2020) Urolithiasis practice patterns following the COVID-19 pandemic: overview from the EULIS collaborative research working group. Eur Urol. https://doi.org/10.1016/j.eururo.2020.04.057CrossRefPubMedPubMedCentral

Antonucci M, Recupero SM, Marzio V, Dominicis MD, Pinto F, Foschi N et al (2020) The impact of COVID-19 outbreak on urolithiasis emergency department admissions, hospitalizations and clinical management in central Italy: a multicentric analysis. Actas Urol Esp S0210–4806(20):30150–30159. https://doi.org/10.1016/j.acuro.2020.06.005CrossRef

Steinberg RL, Johnson BA, Antonelli J, Pearle MS (2020) Urolithiasis in the COVID Era: an opportunity to reassess management strategies. Eur Urol. https://doi.org/10.1016/j.eururo.2020.07.019CrossRefPubMedPubMedCentral

Gökce M, Yin S, Sönmez MG, Eryildirim B, Kallidonis P, Petkova K et al (2020) How does the COVID-19 pandemic affect the preoperative evaluation and anesthesia applied for urinary stones? EULIS eCORE–IAU multicenter collaborative cohort study. Urolithiasis 48(4):345–351. https://doi.org/10.1007/s00240-020-01193-8CrossRefPubMedPubMedCentral

Gul M, Kaynar M, Yildiz M, Batur AF, Akand M, Kilic O et al (2020) The increased risk of complicated ureteral stones in the era of COVID-19 pandemic. J Endourol 34(8):882–886CrossRefPubMed

10.

Ribal MJ, Cornford P, Briganti A, Knolld T, Gravase S, Babjuk M et al (2020) European Association of Urology Guidelines Office Rapid Reaction Group: an organisation-wide collaborative effort to adapt the European Association of Urology guidelines recommendations to the coronavirus disease 2019 era. Eur Urol. https://doi.org/10.1016/j.eururo.2020.04.056CrossRefPubMedPubMedCentral

11.

Goldman HB, Haber GP (2020) Recommendations for tiered stratification of urological surgery urgency in the COVID-19 era. J Urol. https://doi.org/10.1097/JU.0000000000001067CrossRefPubMedPubMedCentral

12.

Proietti S, Gaboardi F, Giusti G (2020) Endourological stone management in the era of the COVID-19. Eur Urol. https://doi.org/10.1016/j.eururo.2020.03.042CrossRefPubMedPubMedCentral

13.

Metzler IS, Sorensen MD, Sweet RM, Harper JD (2020) Stone care triage during COVID-19 at the University of Washington. J Endourol 34:539–540CrossRefPubMed

14.

Tan YQ, Wang Z, Tiong HY, Chua WJ, Wu QH, Chiong E (2020) The START (surgical triage and resource allocation tool) of surgical prioritisation during the COVID-19 pandemic. Urology. https://doi.org/10.1016/j.urology.2020.05.021CrossRefPubMedPubMedCentral

15.

Carneiro A, Wroclawski ML, Nahar B, Soares A, Cardoso AP, Kim NJ et al (2020) Impact of the COVID-19 Pandemic on the Urologist’s clinical practice in Brazil: a management guideline proposal for low- and middle-income countries during the crisis period. Int Braz J Urol 46(4):501–510CrossRefPubMedPubMedCentral

16.

Stensland KD, Morgan TM, Moinzadeh A, Lee CT, Briganti CA, Catto JWF et al (2020) Considerations in the triage of urologic surgeries during the covid-19 pandemic. Eur Urol 77(6):663–666CrossRefPubMedPubMedCentral

17.

Katz EG, Stensland KS, Mandeville JA, MacLachlan LS, Moinzadeh A, Sorcini A et al (2020) Triaging office-based urology procedures during the COVID-19 pandemic. J Urol. https://doi.org/10.1097/ju.0000000000001034CrossRefPubMedPubMedCentral

18.

Ficarra V, Novara G, Abrate A, Bartoletti R, Crestani A, De Nunzio C, et al (2020) Urology practice during COVID-19 pandemic. Minerva Urol Nefrol 72(3):369–375CrossRefPubMed

19.

Yasseri AF, Aghamir SMK (2020) Urinary stone management during the COVID-19 pandemic: a suggested approach and review of literature. Ther Adv Urol 12:1–5. https://doi.org/10.1177/1756287220939513CrossRef

20.

Almeras C, Denis E, Meria P, Estrade V, Raynal G, Hoznek A et al (2020) Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis. Prog Urol 30(8–9):426–429. https://doi.org/10.1016/j.purol.2020.04.021CrossRefPubMedPubMedCentral

21.

Berkow L, Kanowitz A (2020) COVID-19 putting patients at risk of unplanned extubation and airway providers at increased risk of contamination. Anesth Analg. https://doi.org/10.1213/ANE.0000000000004890CrossRefPubMedPubMedCentral

22.

Lie SA, Wong SW, Wong LT, Wong TGL, Chong SY (2020) Practical considerations for performing regional anesthesia: lessons learned from the COVID-19 pandemic. Can J Anaesth. https://doi.org/10.1007/s12630-020-01637-0CrossRefPubMedPubMedCentral

23.

Baig AM, Khaleeq A, Ali U, Syeda H (2020) Evidence of the COVID-19 virus targeting the cns: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci 11(7):995–998. https://doi.org/10.1021/acschemneuro.0c00122CrossRefPubMed

24.

Coroneos E, Assouad M, Krishnan B, Truong LD (1997) Urinary obstruction causes irreversible renal failure by inducing chronic tubulointerstitial nephritis. Clin Nephrol 48(2):125–128PubMed

25.

Spinoit A-F, Haid B, Hiess M, Banuelos B, Hoen L, Radford A et al (2020) Impact of the COVID-19 pandemic on paediatric urology practice in Europe: a reflection from the European Association of Urology Young Academic Urologists. Eur Urol. https://doi.org/10.1016/j.eururo.2020.04.019CrossRefPubMedPubMedCentral

26.

Fukushima H, Kobayashi M, Kawano K, Morimoto S (2018) Performance of quick sequential (sepsis related) and sequential (sepsis related) organ failure assessment to predict mortality in patients with acute pyelonephritis associated with upper urinary tract calculi. J Urol 199:1526–1533CrossRefPubMed

27.

Ling Y, Xu S-B, Lin Y-X, Tian D, Zhu Z-Q, Dai F-H et al (2020) Persistence and clearance of viral RNA in 2019 novel coronavirus disease rehabilitation patients. Chin Med J (Engl) 133(9):1039–1043CrossRef

28.

Wang W, Xu Y, Gao R et al (2020) Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 323(18):1843–1844. https://doi.org/10.1001/jama.2020.3786CrossRefPubMedPubMedCentral

Title: Urolithiasis treatment options during COVID-19 pandemic: review of current recommendations and triage systems
Authors: Ali Abdel Raheem
Ibrahim Alowidah
Mohamed Soliman
Mefarrih Haresy
Ali Almozeni
Sultan Althagafi
Mohamed Almousa
Mohamed Alturki
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Triage
COVID-19
Urolithiasis
Published in: African Journal of Urology / Issue 1/2020
Print ISSN: 1110-5704
Electronic ISSN: 1961-9987
DOI: https://doi.org/10.1186/s12301-020-00085-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Urolithiasis treatment options during COVID-19 pandemic: review of current recommendations and triage systems

Abstract

Background

Main text

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Main text

Conclusion

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