The aim of this study was to analyze temporal trends and regional distribution of nephrectomies within the spectrum of kidney and ureter surgery in Ukraine, including macro-regional and oblast-level characteristics in 2018–2023.

Materials and methods. Data were obtained from the annual statistical reports of the Ministry of Health of Ukraine; indicators of inpatient medical care were analyzed for Ukraine as a whole, for five macro-regions (West, Central, North-East, South-East, South), individual oblasts, and Kyiv. Statistical analysis was performed with IBM SPSS Statistics usinng chi-square and Fisher’s exact tests; p < 0.05 was considered statistically significant.

Results. Over the six-year study period, the total number of kidney and ureter surgeries increased, with the largest relative increase occurring in 2022–2023. The annual number of nephrectomies declined from 2020 to 2022 by 19 %, followed by an increase in 2023. The indications for nephrectomy shifted significantly: the proportions attributable to hydronephrosis and urolithiasis decreased (p < 0.05) in 2021–2023, and to malignant renal neoplasms in 2021 (p < 0.001), despite an otherwise stable proportion over 2018–2020 and 2022–2023. The proportions attributable to benign renal neoplasms and pyelonephritis increased from 2019 onward, with both groups reaching higher percentages in 2022–2023 than in 2018. In patients with nephrolithiasis, the absolute number of nephrectomies declined by 25 % between 2018 and 2023; during the same period, nephrectomies for pyelonephritis/pyelonephrosis increased by 200 % in absolute terms.

Conclusions. Distinct temporal trends and regional variation in nephrectomy rates across Ukraine were identified for 2018–2023. These patterns are temporally consistent with the effects of the COVID-19 pandemic (2020–2021) and the ongoing armed conflict (from 2022) and are associated with a statistically significant increase in the proportions of nephrectomies performed in the Central, Western, and North-Eastern regions, accompanied by a decrease in the Southern regions and Kyiv (p < 0.001).