Abstracts from the New England Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Scientific Session II: Stones I Evaluating Spontaneous Stone Passage Rates During the COVID-19 Pandemic Stephanie Hanchuk, MD , Eric Ghiraldi, DO, Matthew Buck, BA, Hari Nair, BA, Dinesh Singh, MD, Piruz Motamedinia, MD Yale School of Medicine, New Haven, CT, USA Introduction: During the COVID-19 pandemic our institution limited elective surgery including management of kidney stones. Additionally, patients themselves were reluctant to pursue elective surgery. This presented us a unique opportunity to reassess the natural history of symptomatic nephrolithiasis given potentially prolonged periods of conservative management. Materials & Methods: A retrospective review was performed of patients presenting to the emergency room (ER) with flank pain secondary to nephrolithiasis from March to April of 2020 (COVID peak period of elective surgery limitations), and a comparative cohort from March and April 2019. Assessed outcomes included definitive stone treatment at initial presentation to the ER, rate of spontaneous stone passage, and time to elective surgery from initial ER presentation. Chi-square or Mann- Whitney U tests were utilized for dependent binary variables and continuous variables, respectively. A KaplanMeier analysis was used to demonstrate differences in time to elective surgery between the two eras. Results: Baseline characteristics did not differ between groups ( Table 1 ). Patients discharged from the ER were more often offered medical expulsive therapy (71.6%vs. 55.0%, p = 0.026) during the COVID era. The rate of surgical stone management or stent placement at initial presentation did not differ, however, discharged patients waited longer from initial ER presentation to elective surgery (55.3 vs. 33.1 days, p = 0.02) ( Figure 1 ). Spontaneous stone passage rates were similar between groups despite the delay, and similar stone location and stone size between eras. Conclusions: During the height of the COVID pandemic, ER patients with symptomatic stones had similar characteristics at presentation but were more often offered MET. Spontaneous stone passage during the pandemic was no different than in 2019, despite a significant difference in time to elective surgery from initial presentation to the ER with flank pain. Multidisciplinary Stone Clinic May be Associated with Equalizing Urine Volume Irrespective of Socioeconomic Status Ji Whae Choi, BA 1 , Timothy K. O’Rourke, Jr., MD 1 , Frances Kazal, BA 1 , Kathleen Wu, BA 1 , Rebecca Ortiz, BA 2 , Philip Caffery, PhD 2 , Christopher T. Tucci, MS 1 , Jie Tang, MD 1 , Mary Lynch-Delaney, RD, LDN 2 , Gyan Pareek, MD, FACS 1 , David W. Sobel, MD 1 1 Minimally Invasive Urology Institute, The Miriam Hospital; The Warren Alpert Medical School of Brown University, Providence, RI, USA; 2 Minimally Invasive Urology Institute, The Miriam Hospital, Providence, RI, USA Introduction : Poor fluid intake and associated low urine volume (<2 L) on 24-hour urine collection are known risk factors for nephrolithiasis. Kidney stone risk is higher in certain demographics, and low 24-hour urine volumes have been associated with certain socioeconomic status such as low-income. We aimed to compare 24-hour urine volumes amongst high-risk stone formers followed in a multidisciplinary stone clinic (MSC) where patients are seen by urologists, nephrologists, and dietitians in one patient encounter. Materials & Methods : A retrospective review of patient records at a single academic medical center MSC was conducted. Patient demographics (race/ ethnicity, gender assigned at birth, insurance status, and religious status) and 24-hour urinary volume were collected. Urine volumes of patients who completed multiple 24-hour urine collections were averaged to produce one mean urine volume per patient. T-tests andANOVAwere used for statistical analysis to assess for differences between groups. Results : A total of 117 patients were included in the analysis with an overall mean 24-hour urine volume of 1,980+-684 mL. No significant difference was detected between white and non-white patients (1,893+-754 mL versus 1,977+-671 mL respectively, p =0.645) and between female and male patients (1,917+-757 mL vs. 2,019+-577 mL respectively, p =0.409). Patients with Medicare, Medicaid, and private insurance had similar urine volumes (1,851+- 562 mL vs. 1,882+-673 mL vs. 2,018+-713 mL respectively, F(2,114)=0.641, p =0.529). Christian, Jewish, and non-religious groups had similar urine volumes (1,974+-667 mL vs. 2,082+-675 mL vs. 1,811+-873 mL respectively, F(2,114)=0.327, p =0.722). Conclusions : There were no significant differences in 24-hour urine volume among patients fromdifferent socioeconomic status related to race/ethnicity, gender assigned at birth, insurance, and religion. Although previous studies suggest an increased risk for kidney stones in certain demographics, this study demonstrates that an MSC model may optimize the patients’ risk factors for stone formation irrespective of their socioeconomic status. Thus, clinicians should consider the potential benefit of a multidisciplinary approach in stone formers across all social determinants of health. Further investigations are necessary to characterize the impact of MSC in different populations. 18 17 10