To defer or not to defer? A German longitudinal multicentric assessment of clinical practice in urology during the COVID-19 pandemic.

After the outbreak of COVID-19 unprecedented changes in the healthcare systems worldwide were necessary resulting in a reduction of urological capacities with postponements of consultations and surgeries.

An email was sent to 66 urological hospitals with focus on robotic surgery (RS) including a link to a questionnaire (e.g. bed/staff capacity, surgical caseload, protection measures during RS) that covered three time points: a representative baseline week prior to COVID-19, the week of March 16th-22nd and April 20th-26th 2020. The results were evaluated using descriptive analyses.

27 out of 66 questionnaires were analyzed (response rate: 41%). We found a decrease of 11% in hospital beds and 25% in OR capacity with equal reductions for endourological, open and robotic procedures. Primary surgical treatment of urolithiasis and benign prostate syndrome (BPS) but also of testicular and penile cancer dropped by at least 50% while the decrease of surgeries for prostate, renal and urothelial cancer (TUR-B and cystectomies) ranged from 15 to 37%. The use of personal protection equipment (PPE), screening of staff and patients and protection during RS was unevenly distributed in the different centers-however, the number of COVID-19 patients and urologists did not reach double digits.

The German urological landscape has changed since the outbreak of COVID-19 with a significant shift of high priority surgeries but also continuation of elective surgical treatments. While screening and staff protection is employed heterogeneously, the number of infected German urologists stays low.

PloS one. 2020 Sep 15*** epublish ***

Nina N Harke, Jan P Radtke, Boris A Hadaschik, Christian Bach, Frank P Berger, Andreas Blana, Hendrik Borgmann, Florian A Distler, Sebastian Edeling, Tobias Egner, Christina L Engels, Mahmoud Farzat, Alexander Haese, Rainer Hein, Markus A Kuczyk, Andreas Manseck, Rudolf Moritz, Michael Musch, Inga Peters, Sasa Pokupic, Bernardo Rocco, Andreas Schneider, André Schumann, Christian Schwentner, Chiara M Sighinolfi, Stephan Buse, Jens-Uwe Stolzenburg, Michael C Truß, Michael Waldner, Christian Wülfing, Volker Zimmermanns, Jörn H Witt, Christian Wagner

Department of Urology and Urologic Oncology, Hanover Medical School, Hanover, Germany., Department of Urology, University of Duisburg-Essen, Essen, Germany., Department of Urology, RWTH Aachen University, Aachen, Germany., Department of Urology, University of Jena, Jena, Germany., Department of Urology, Fürth Hospital, Fürth, Germany., Department of Urology, Johannes Gutenberg University Medical Center, Mainz, Germany., Department of Urology, Paracelsus Medical University, Nuremberg, Germany., Department of Urology, Da Vinci Zentrum, Hanover, Germany., Department of Urology, Klinikum Würzburg Mitte, Würzburg, Germany., Department of Urology, Municipal Hospital Karlsruhe, Karlsruhe, Germany., Department of Urology, Diakonie Klinikum, Siegen, Germany., Martini-Klinik Prostate Cancer Center, University Clinic Hamburg-Eppendorf, Hamburg, Germany., Department of Urology, Klinikum Magdeburg, Magdeburg, Germany., Department of Urology, Klinikum Ingolstadt, Ingolstadt, Germany., Department of Urology, Marien Hospital, Ruhr-University Bochum, Herne, Germany., Department of Urology, Pediatric Urology and Urologic Oncology, Kliniken Essen-Mitte, Essen, Germany., Department of Urology, Asklepios Klinikum Harburg, Hamburg, Germany., Department of Urology, University of Modena and Reggio Emilia, Modena, Italy., Department of Urology, Main-Kinzig-Kliniken Standort Gelnhausen, Gelnhausen, Germany., Department of Urology and Kidney Transplantation, Martin Luther University, Halle (Saale), Germany., Department of Urology, Diakonieklinikum Stuttgart, Stuttgart, Germany., Department of Urology and Urologic Oncology, Alfried Krupp Krankenhaus, Essen, Germany., Department of Urology, University of Leipzig, Leipzig, Germany., Department of Urology, Klinikum Dortmund, Dortmund, Germany., Department of Urology, St. Elisabeth Krankenhaus Köln-Hohenlind, Köln, Germany., Department of Urology, Asklepios Klinik Altona, Hamburg, Germany., Department of Urology, Siloah St. Trudpert Klinikum, Pforzheim, Germany., Department of Urology, Pediatric Urology and Urologic Oncology, Prostate Center Northwest, St. Antonius Hospital Gronau, Gronau, Germany.