Urological emergency activities during COVID-19 pandemic: Our experience

Abstract

Background: The Coronavirus Disease (COVID-19) is causing a significant health emergency which is overturning dramatically routine activities in hospitals. The outbreak is generating the need to provide assistance to infected patients and in parallel to treat all nondeferrable oncological and urgent benign diseases. A panel of Italian urologists agreed on possible strategies for the reorganization of urological routine practices and on a set of recommendations that should facilitate a further planning of both inpatient visits and surgical activities during the COVID- 19 pandemic. According to this only urgent benign and nondeferrable oncological activities have been kept. Materials and methods: We have considered urgent outpatient visits requested by Emergency Department (ED) or by General Practitioner (GP) and emergency surgical procedures performed in our Urology Unit from March 9th to April 14th 2020, during COVID-19 pandemic. These figures have been compared to those observed last year from March 9th to April 14th 2019. Results: Our data show that urgent care visits decreased during COCID-19 pandemic (from 293 to 179). Urgent care visits of patients who accessed directly to the ED decreased (from 219 to 107) whereas the number of urgent care visits referred by GP remained unchanged (74 vs 72). Consequently, the rate of visits from ED decreased from 75% to 60% and the rate of visit requested by GP increased from 25% to 40% (p = 0.001). Particularly, the rate of visits for renal colic, LUTS and other not precisely defined disorders from ED decreased and the corresponding rates of visits of patients referred by GPs increased significantly (p = 0.0001, p = 0.0180 and p = 0.0185, respectively). The rate of visits for acute urinary retention, hematuria, sepsis, acute scrotum, cystitis, prostatitis and genito-urinary trauma from ED and GP remained unchanged. Finally, urgency endourology and surgical activities have been stable in relation to the same period last year. Conclusions: Urological emergency activities during COVID- 19 pandemic are more appropriate since urgent outpatients’ visits required by ED are decreased and emergency surgical and endourological procedures are stable.

Comparison of the outcomes of testicular torsion among children presenting during the Coronavirus Disease 2019 (COVID-19) pandemic versus the pre-pandemic period: A systematic review and meta-analysis

“…A recent systematic review demonstrated that access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures [32]. Further research into COVID-19 effects on urologic emergencies was conducted, with one study demonstrating that urgent care visits from patients directly to the emergency department decreased (from 219 to 107) while those urgent care visits who were referred by their general practitioners remained unchanged (74 to 72) when comparing the same periods (from March 9th to April 14th) in 2020 (during the time of COVID-19 pandemic) and 2019 (before the pandemic) [33]. The same study highlighted that the rate of visits for each of the emergencies including the acute scrotum, acute urinary retention, hematuria, cystitis, prostatitis, sepsis, and genito-urinary trauma from the emergency department and general practitioners remained unchanged when comparing the two time periods [33].…”

The impact of Covid-19 pandemic on urological emergencies, 8 months results of a multicenter retrospective study from Turkey

“…Although there are similar studies in the literature, these studies generally covered a period of several months during the 1 st months of the pandemic. [2,3] Our study, on the other hand, is the first study that discussed a slightly longer period of 8 months and compared it with the previous year.…”

“…In particular, along with the effect of restrictions such as the curfew announced during the 1 st months of the pandemic, there was a significant decrease in non-COVID patient admissions to hospitals, which is considered to be due to the fact that patients could not apply to hospitals by delaying their complaints for the fear of COVID-19. [2][3][4] We consider that emergency surgical procedures increased during the pandemic period as a result of this delay.…”

The impact of the Covid-19 pandemic on the short and mid-term urological emergencies and the emergency department

“…Our study showed that there was a decrease of 31.05% in admissions to the emergency department during the 8-month pandemic period compared to the previous year in a similar period. In the studies covering the early stages of the pandemic, it was reported that there was a decrease in admissions to the emergency department (14,15). In a study covering the first 4-week early pandemic period in America, this decrease was found to be 42%, and another study found a decrease of 31%-45% although there was a difference by regions in America (16,17).…”