This Month in Adult Urology

Abstract

Medicine and society changed in early 2020. Worldwide shutdowns because of COVID-19 affected life for everyone but had a particular impact on hospitals and patients. The Journal of UrologyÒ chronicled many of the important changes that occurred from use of telemedicine, remote learning and proper allocation of hospital resources. Further, multiple publications in The Journal and elsewhere described methods for appropriate triage of nonCOVID patients and, in particular, performance of nonurgent or emergent surgery. These comments are being prepared months before the publication date for this issue which will be the first of the new year. What further impact COVID-19 or other unanticipated problems will have is very difficult to predict. One hopes, though, that important lessons have been learned.This issue of The Journal features a critical evaluation by Cohn et al (page 241) of scoring systems commonly used for prioritization of elective urological surgery during the pandemic. 1 Some methods relied on complex formulas, others consensus expert opinion, and still others used surgeon based scoring. None was validated and all were rapidly put into place. The study shows that the different systems result in substantially different prioritization. A sober analysis of the strengths and weaknesses of each system can help planning for future needs.