Exploring Urological Experience in the COVID-19 Outbreak: American Confederation of Urology (CAU) Survey.

To explore the current situation faced by Latin American urology departments during the COVID-19 Outbreak in terms of knowledge, actions, prioritization of urology practices, and implementation of internal clinical management protocols for inpatients and outpatients.

A non-validated, structured, self-administered, electronic survey with 35 closed multiple choice questions was conducted in Spanish, Portuguese, Italian, and English and Deutsch versions from April 1st to April 30th, 2020. The survey was distributed through social networks and the official American Confederation of Urology (CAU) website. It was anonymous, mainly addressed to Latin American urologists and urology residents. It included 35 questions exploring different aspects: 1) Personal Protective Equipment (PPE) and internal management protocols for healthcare providers; 2) Priority surgeries and urological urgencies and 3) Inpatient and outpatient care.

Of 864 surveys received, 846 had at least 70% valid responses and were included in the statistical analyses. Surveys corresponded to South America in 62% of the cases, Central America and North America in 29.7%. 12.7% were residents. Regarding to PPE and internal management protocols, 88% confirmed the implementation of specific protocols and 45.4% have not received training to perform a safe clinical practice; only 2.3% reported being infected with COVID-19. 60.9% attended urgent surgeries. The following major uro-oncologic surgeries were reported as high priority: Radical Nephrectomy (RN) 58.4%, and Radical Cystectomy (RC) 57.3%. When we associate the capacity of hospitalization (urologic beds available) and percentage of high-priority surgery performed, we observed that centers with fewer urological beds (10-20) compared to centers with more urological beds (31-40) performed more frequently major urologic cancer surgeries: RN 54.5% vs 60.8% (p=0.0003), RC 53.1% vs 64.9% (p=0.005) respectively.

At the time of writing (May 13th 2020) our data represents a snapshot of COVID-19 outbreak in Latin American urological practices. Our findings have practical implications and should be contextualized considering many factors related to patients and urological care: The variability of health care scenarios, institutional capacity, heterogeneity and burden of urologic disease, impact of surgical indications and decision making when prioritizing and scheduling surgeries in times of COVID-19 pandemic.

International braz j urol : official journal of the Brazilian Society of Urology. 2020 Jul [Epub]

Ana María Autrán-Gómez, Ignacio Tobia, Ricardo Castillejos Molina, Francisco Rodríguez Covarrubias, Frank Benzing, Serena Maruccia, Leonardo de O Reis, Ramón Rodríguez Lay, Marcelo Torrico De la Reza, Felix Santaella Torres, Andrés Hernández Porras, Alejandro Rodríguez

Department of Urology, University Hospital Fundación Jiménez Díaz, Madrid, Spain., Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico., Department of Urology, Brandenburg Medical School University Hospital Brandenburg der Havel, Germany., Department of Urology, Institute Zucchi, Monza, Italy., Departamento de Urologia, UroScience, Universidade Estadual de Campinas - Unicamp, Campinas, SP, Brasil., Clinic Urology Service, Complejo Hospitalario Metropolitano, Caja de Seguro Social Dr. Arnulfo Arias Madrid, Panama., Clinic Urology Service, Los Olivos, San Simón Higher University Cochabamba, Bolivia., Department of Urology, Centro Médico Nacional, La Raza, Hospital de Especialidades -Instituto Mexicano del Seguro Social Mexico, Mexico-City., Department of Urology, Hospital Angeles Tiujana, Baja California Norte, Mexico., Department of Urology, Rochester General Hospital, Rochester New York, US.