The impact of COVID-19 on the management of renal colic including surgical interventions during the first wave of the pandemic

14 Mechanisms of promoting safer intrarenal pressure during flexible ureterorenoscopy Eoin MacCraith, Lee C. Yap, Mutaz Elamin, Kenneth Patterson, Ciaran M. Brady, Derek B. Hennessey Mercy University Hospital, Cork, Ireland Introduction: Elevated intrarenal pressure (IRP) during flexible ureterorenoscopy (FURS) is a predictor of postoperative complications. The aim of this study is to evaluate IRP during FURS in a porcine kidney model in order to determine the safest combination of irrigation device, ureteral access sheath (UAS) and ureteroscope. Methods: Urinary tracts were harvested from Landrace pigs slaughtered for the food chain. Two flexible ureteroscopes, 8.7Fr and 9.5Fr were evaluated. Irrigation systems evaluated included; TraxerFlow (Rocamed, France), SAPS single action pumping system (Boston Scientific, USA), Pathfinder Plus (Utah Medical, USA), and a manual “bag squeeze”. This experiment was conducted with no UAS, followed by an 11/13Fr UAS and then a 12/14Fr UAS. IRPs were measured in the prepared porcine kidney during all possible combinations of scope, UAS and irrigation system. Results: Pressures were significantly reducedwhen using 12/14Fr UAS compared to 11/13Fr UAS (p = 0.006) and when using 11/13Fr UAS compared to no UAS (p = 0.02). Pressures were significantly reduced with the 8.7Fr scope compared to the 9.5Fr scope (p = 0.001). SAPS generates significantly greater IRP than TraxerFlow, Pathfinder Plus and a “bag squeeze” (p < 0.05). The most dangerous combination was using the SAPS, no UAS and larger ureteroscope leading to an IRP of 100.6 ± 16.1 cmH20. The safest combination was using Pathfinder Plus with a 12/14Fr UAS and smaller ureteroscope giving an IRP of 11.6 ± 3.65 cmH20. Conclusion: In order to maintain safe IRPs during FURS urologists should use large UAS, narrow ureteroscopes and be cautious in selection of an irrigation device. Abstract 15 Development of a 3D-printed biodegradable15 Development of a 3D-printed biodegradable sling for stress urinary incontinence surgery Eoin MacCraith, Michael Joyce, Ronaldo J.F.C. Do Amaral, EoghanM. Cunnane, James C. Forde, Fergal J. O’Brien, Niall F. Davis Royal College of Surgeons in Ireland, Tissue Engineering Research Group, Dublin, Ireland; Blackrock Clinic, Dublin, Ireland Introduction: The aim of this study is to design a biodegradable synthetic sling fabricated using 3D printed polycaprolactone (PCL) to be used for stress urinary incontinence (SUI) surgery and compare it to existing products. Methods: PCL meshes were 3D printed using a fused deposition modelling (FDM) printer. A PCL-collagen composite scaffold was also fabricated for evaluation. Uniaxial tensiometry was performed to mechanically compare the candidate scaffolds with commercially available polypropylene (PP) mesh (Gynecare TVTTM Exact) and acellular porcine dermal collagen (PelvicolTM). Murine mesenchymal stem cells (MSCs) were seeded onto PCL and PCL-collagen scaffolds and interval assessments of cell viability were performed. Results: The PCL scaffold was significantly less stiff than PP (elastic modulus: 0.02 ± 0.01 MPa versus 0.06 ± 0.01 MPa, p = 0.0006) and PelvicolTM (elastic modulus: 0.02 ± 0.01 MPa versus 0.13 ± 0.01 MPa, p < 0.0001). PCL also had an ultimate tensile strength closest to that of healthy native pelvic floor tissue when compared to PP and PelvicolTM (1.52 ± 0.07 MPa versus 7.17 ± 0.25 MPa versus 5.47 ± 0.05 MPa). There was no difference between the PCL scaffolds and the PCL-collagen scaffolds in terms of mechanical properties. Viable cells were seen on PCL scaffolds at 28 days demonstrating that the newmaterials retained significant biological functionality. Conclusions: The mechanical properties of PCL are more favourable for pelvic floor reconstructive surgery compared to PP and porcine collagen. In addition, PCL scaffolds provide good cellular biocompatibility indicating that PCL may integrate into tissues as it biodegrades. Financial disclaimers: This research was funded by the RCSI – Blackrock Clinic StAR MD programme 2020. Abstract 16 The impact of COVID-19 on themanagement of16 The impact of COVID-19 on themanagement of renal colic including surgical interventions during the first wave of the pandemic Caroline Anna Woo, Mohammed Kamil Quraishi, Joseph Gabriel, Simon Mackie, Graham Watson Eastbourne Hospital, Eastbourne, United Kingdom Introduction: Management of renal colic has changed as a result of COVID-19, with an overall aim of reducing hospital admissions and preventing stone related morbidity. We aim to review how the treatment of acute renal colic has been affected by comparing similar times in 2019 to 2020. Methods: A retrospective study of all new presentations of acute renal colic admissions during 01/04/2019–31/05/2019 were compared to 01/04/2020–31/05/2020, with data such as demographics of patients, clinical features, stone characteristics and treatment noted. Results: 38 patients were admitted in 2019, compared to 40 in 2020. Ureteric stones were commonly found in both years (79%in2019 and 85%in2020) than renal stones, with the majority of ureteric stones located distally. The 2020 cohort saw more conservative management (25%vs21%), as well as a decrease in emergency decompression (stent/nephrostomy) European Urology Open Science 31(S1), (2021), S1–S30 S8