Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for CO-VID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. Materials and Methods: A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. Results: Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). Conclusion: In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.

Changing patterns of urologic emergency visits and admissions during the COVID-19 pandemic: a retrospective, multicenter, nationwide study

“…Arch Med Sci or ureteral stenting), transurethral resection of bladder tumor, and testicular detorsion between a pre-COVID period in 2020 and during the massive outbreak in Italy [6]. In our cohort, the distribution of the interventions was non-significantly different with an 8% decrease in absolute numbers of endoscopic procedures in 2020.…”

“…In China, Italy, the UK, and the US, initial reports suggest a decrease in visits to emergency departments (EDs) and admissions for urgent cardiac and neurological conditions [1][2][3][4][5]. In Italy and Portugal, there is also evidence of a decrease in ED visits and admissions for urgent urologic conditions but mostly reported in studies of a single center or a short duration [6][7][8][9][10].…”

Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients’ Perspective

“…Several cross-sectional surveys, investigating the impact of COVID-19 on urological services worldwide, confirmed that the pandemic has imposed great challenges to urology health care providers. In fact, a significant cut-down in urology clinics, outpatient procedures, major surgeries, and urgent/emergent urological care has been reported 2 , 9 .…”

The Effect of the Presence of Lower Urinary System Symptoms on the Prognosis of COVID-19: Preliminary Results of a Prospective Study

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