Background: Rising healthcare demands and the impact of the COVID-19 pandemic have prompted a transition from inpatient to day-case ureterorenoscopy (URS) to reduce costs and optimise bed capacity. Although international studies support the safety of day-case URS, evidence from The Netherlands is limited. Furthermore, Dutch and European urological guidelines do not provide explicit recommendations for standardising URS as a day-case procedure. The present study compares 30-day complication rates of URS between the pre-COVID-19 era (2019) and current practice (2023). Methods: A retrospective cohort study was conducted, including all patients who underwent elective URS at Canisius Wilhelmina Hospital, the Netherlands, in 2019 and 2023. Patients under 18 years of age, as well as those undergoing emergency procedures and combined procedures, were excluded. The primary outcome was the occurrence of complications within 30 days, classified according to the Clavien–Dindo system. Secondary outcomes included identification of clinical and procedural predictors of complications. Statistical analysis was performed using SPSS and included Chi-square tests, t-tests, Mann–Whitney U tests, and multivariable logistic regression. Results: Of 619 screened patients, 495 were included: 230 patients in 2019, 265 patients in 2023. Baseline characteristics were comparable between groups. The overall complication rate was low (15.7% in 2019, 20.0% in 2023) and did not differ significantly between day-case and inpatient URS (p = 0.209). In multivariable logistic regression, day-case URS was not associated with an increased risk of complications (OR = 0.91, 95% CI 0.46–1.81, p = 0.795). There were no other significant predictors of complications. Conclusions: The findings suggest that day-case ureterorenoscopy may be a safe and feasible approach and may offer opportunities for cost savings, as no increase in postoperative complications was observed compared with inpatient procedures. However, these results should be interpreted with caution given the observational design.
Slagmaat et al. (Wed,) studied this question.