Changes in Urology After the First Wave of the COVID-19 Pandemic

Margel, David; Ber, Yaara

doi:10.1016/j.euf.2020.05.001

Cited by 14 publications

(15 citation statements)

References 5 publications

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“… 13 On the other hand, there is a real concern about the impact that delayed treatments could have, especially for oncological patients waiting for surgery. 5 , 7 , 14 …”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the post-COVID-19 era

García‐Rojo

Manfredi

Santos-Pérez-De-La-Blanca

et al. 2021

Actas Urológicas Españolas (English Edition)

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Introduction The suspension of most elective surgeries during COVID-19 pandemic caused the lengthening of urology surgical waiting lists. The objective of this study is to evaluate the impact of COVID-19 pandemic on urology surgical waiting list in a high-volume hospital. Methods An observational descriptive study was designed. All patients included in the urology surgical waiting list of our high-volume center on May 1 st 2020 (46 days after the suspension of elective surgery) were analyzed. Baseline variables, priority on the waiting list, main urological disease, type of scheduled surgery, and waiting time were recorded. Other variables recorded were the presence of a urinary catheter, number of accesses to the emergency department, evidence of COVID-19 infection, number of deaths and their cause. The waiting time for each disease was compared with the time to surgery in 2019. Results A total of 350 patients were included. The mean (SD) time on the waiting list was 97.33 (55.47) days. Priority 1 patients, who normally should undergo surgery within 30 days, were on the waiting list for a mean (SD) time of 60.51 (20.14) days. They were mainly patients with ureteral lithiasis (25.6%), high-risk or muscle-invasive bladder cancer (20.9%) and high-risk prostate cancer (13.9%). The mean waiting time had already significantly exceeded the mean time to surgery in 2019 for radical cystectomy (p = 0.04) and URS (p = 0.003). Conclusions The suspension of most elective surgeries due to COVID-19 had a significant impact on urology surgical waiting list of our high-volume center, especially in priority 1 group.

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“… 13 On the other hand, there is a real concern about the impact that delayed treatments could have, especially for oncological patients waiting for surgery. 5 , 7 , 14 …”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the post-COVID-19 era

García‐Rojo

Manfredi

Santos-Pérez-De-La-Blanca

et al. 2021

Actas Urológicas Españolas (English Edition)

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“…All of these variables were also recorded week‐by‐week at the same time interval of the year 2019. Other surgical and diagnostic approaches were not analysed as guidelines regarding Covid‐19 pandemic suggested the postponement of nearly all surgeries for female urology, andrology and some other elective surgical operations 8,9,11,12 . The centres were divided into three groups as tertiary referral centres, state hospitals and private practice hospitals.…”

Section: Methodsmentioning

confidence: 99%

“…Most of the hospitals turned to pandemic or quarantine hospitals and had to serve only Covid‐19 patients. Some detailed recommendations were published for the triage of urological surgeries during the Covid‐19 pandemic 7–10 . Like other surgical subspecialties, cancellation of elective surgeries and utilisation of solely emergent surgeries and non‐deferrable oncologic surgeries that delay may cause negative impact on survival have been performed in urology clinics according the triage recommendations 11 .…”

Section: Introductionmentioning

confidence: 99%

Nation‐wide analysis of the impact of Covid‐19 pandemic on daily urology practice in Turkey

Bozkurt

Şen²,

İrer

et al. 2020

Int J Clin Pract

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Objective To present a nation‐wide analysis of the workload of urology departments in Turkey week‐by‐week during Covid‐19 pandemic. Methodology The centers participating in the study were divided into three groups as tertiary referral centers, state hospitals and private practice hospitals. The number of outpatients, inpatients, daily interventions and urological surgeries were recorded prospectively between 9‐March‐2020 and 31‐May‐2020. All these variables were recorded for the same time interval of 2019 as well. The weekly change of the workload of urology during pandemic period was evaluated; also the workload of urology and the distributions of certain urological surgeries were compared between the pandemic period and the same time interval of the year 2019. Results A total of 51 centers participated in the study. The number of outpatients, inpatients, urological surgeries and daily interventions were found to be dramatically decreased by the third week of pandemics in state hospitals and tertiary referral centers; however the daily urological practice were similar in private practice hospitals throughout the pandemic period. When the workload of urology in pandemic period and the same time interval of the year 2019 were compared; a huge decrease was observed in all variables during pandemic period. However, temporary measures like ureteral stenting, nephrostomy placement and percutaneous cystostomy have been found to increase during Covid‐19 pandemic compared to normal life. Conclusions Covid‐19 pandemic significantly effected the routine daily urological practice likewise other subspecialties and priority was given to emergent and non‐deferrable surgeries by urologists in concordance with published clinical guidelines.

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“…Moreover, the burden of non-oncological therapies in functional urology and stone disease is accumulating [22,23], calling for novel strategies not to compromise the quality of life of patients. In this regard, the field of urology has the chance not only to adapt to the current pandemic by taking immediate actions for outpatient clinics, operating rooms, department structure and research, but also to prepare for its intermediate and long-term future by integrating telemedicine and technology into routine clinical practice [24].…”

Section: Yes Nomentioning

confidence: 99%

Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic

et al. 2020

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Objectives While the coronavirus disease 2019 (COVID-19) pandemic captures healthcare resources worldwide, data on the impact of prioritization strategies in urology during pandemic are absent. We aimed to quantitatively assess the global change in surgical and oncological clinical practice in the early COVID-19 pandemic. Methods In this cross-sectional observational study, we designed a 12-item online survey on the global effects of the COVID-19 pandemic on clinical practice in urology. Demographic survey data, change of clinical practice, current performance of procedures, and current commencement of treatment for 5 conditions in medical urological oncology were evaluated. Results 235 urologists from 44 countries responded. Out of them, 93% indicated a change of clinical practice due to COVID-19. In a 4-tiered surgery down-escalation scheme, 44% reported to make first cancellations, 23% secondary cancellations, 20% last cancellations and 13% emergency cases only. Oncological surgeries had low cancellation rates (%): transurethral resection of bladder tumor (27%), radical cystectomy (21-24%), nephroureterectomy (21%), radical nephrectomy (18%), and radical orchiectomy (8%). (Neo)adjuvant/palliative treatment is currently not started by more than half of the urologists. COVID-19 high-risk-countries had higher total cancellation rates for non-oncological procedures (78% vs. 68%, p = 0.01) and were performing oncological treatment for metastatic diseases at a lower rate (35% vs. 48%, p = 0.02). Conclusion The COVID-19 pandemic has affected clinical practice of 93% of urologists worldwide. The impact of implementing surgical prioritization protocols with moderate cancellation rates for oncological surgeries and delay or reduction in (neo)adjuvant/palliative treatment will have to be evaluated after the pandemic.

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Changes in Urology After the First Wave of the COVID-19 Pandemic

Cited by 14 publications

References 5 publications

Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the post-COVID-19 era

Impact of COVID-19 outbreak on urology surgical waiting lists and waiting lists prioritization strategies in the post-COVID-19 era

Nation‐wide analysis of the impact of Covid‐19 pandemic on daily urology practice in Turkey

Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic

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