COVID-19 outbreak represented an unprecedented event that led to a redefinition of health care systems worldwide. The impact of the emergency required a deviation of the care toward the assistance to COVID-19 patients, with reduction of resources for elective activities, including surgery. We aim to report the decrease of urological surgical activity during the first weeks from the beginning of the pandemic, aiming to highlight the prioritization we applied to select patients for surgery

A. Antonelli

A. Caffarelli

A. Calori

A. Celia

A. Cocci

A. Corsaro

A. Galfano

A. L. Pastore

A. M. Bocciardi

A. Minervini

A. Porreca

A. Tafuri

A. Volpe

B. Dall’Oglio

B. Rocco

C. Ceruti

C. Sciorio

C. Terrone

D. D’Agostino

D. Veneziano

F. Annino

F. Gaboardi

F. Gallo

F. Greco

G. Bozzini

G. Cacciamani

G. Costa

G. Pini

L. Berti

L. Cindolo

L. Costantino

L. Pucci

L. Spirito

M. Amenta

M. Borghesi

M. C. Sighinolfi

M. Falsaperla

M. Finocchiaro

M. Oderda

M. Sandri

M. Schenone

O. Dalpiaz

P. Bove

P. Parma

P. Umari

P. Verze

R. Baio

R. Bertolo

R. Falabella

R. Nucciotti

R. Schiavina

S. Crivellaro

S. Micali

S. Zaramella

V. Altieri

V. Pagliarulo

V. Varca

English

Archivio della ricerca- Università di Roma La Sapienza

Smart Communications (SC347–SC349)COVID-19SmartCommunicationsTitleSC347 Safety of urologic elective surgery in a covid-hospitalSC348 Surgical activity in the COVID-19 era: trend of slowdown from a multicentre observational studySC349 Telemedicine during COVID-19 pandemic by a tertiary referral neurourology centerSC347 Safety of urologic elective surgery in a covid-hospitalO. Blezien, F. Molinari, S. Guzzo, C. Vaccaro, C. Signorini, A. Conti,D. Vizziello, L. Carmignani (Milano)Introduction: To demonstrate safety of a new internal protocol forpatients and health workers adopted for elective urologic surgicalactivity during COVID-19 pandemic.Materials and methods: We have retrospectively evaluated 86patients who underwent elective surgery in the urology departmentof IRCCS Policlinico San Donato, fromMarch 9th toMay 8th, 2020. Ourinstitution became a first line hospital for COVID-19 patients sinceMarch 2020. We identified non-deferrable patients that needed to betreated within one month. All patients included have followed adedicated pathway from the day-hospital till the discharge. Clinicaldata, as nasopharyngeal swabs, chest X-ray, type of anesthesia, type ofsurgical procedure and days of hospitalization were collected.Moreover, individual risk factors for COVID-19 pneumonia, asadvanced age, ongoing malignancy, high blood pressure and coronaryartery disease, were analyzed. All patients were interviewed after aminimum post discharge time of 14 days to find out if any of them haddeveloped general and Covid-related complications.Results: The study population included 66 (76.75%) men and 20(23.25%) women, aged between 17 and 90 years old. We haveperformed eighty-eight (88) preoperative screenings and two (2)patients were excluded, due to exclusion criteria. Overall, 63 (71.60%)patients underwent oncological procedures while only 23 (28.40%)patients underwent non-oncological surgery. The average number ofhospitalization days was 2.39 ± 2.21. After at least 14 days afterdischarge (25.00 ± 10.35 days), we phone interviewed all patients tocheck their conditions. No patients included in the study showedsymptoms related to COVID-19, except for 2 (2.32%) who manifestedcoryza, 28 and 35 days after discharge respectively. We also analyzedclinical characteristics of the study participants in relation to developSARS CoV-2. None of patient developed Covid-19 postoperatively andin addition, none of hospital workers that were part of this pathwaygot the Covid-19 infection.Conclusions: The duration of pandemic period is undefined; there-fore, our protocol could be considered a good model for every type ofsurgery and its application could ensure a continuous treatment fornon-deferrable conditions, even during healthcare emergencies in asafe way for both the patients and health workers.SC348 Surgical activity in the COVID-19 era: trend ofslowdown fromamulticentre observational studyB. Rocco, M.C. Sighinolfi, M. Sandri, V. Altieri, M. Amenta, F. Annino,A. Antonelli, R. Baio, R. Bertolo, A.M. Bocciardi, M. Borghesi, P. Bove,G. Bozzini, G. Cacciamani, A. Calori, A. Caffarelli, A. Celia, A. Cocci,A. Corsaro, G. Costa, C. Ceruti, L. Cindolo, S. Crivellaro, O. Dalpiaz,D. D’Agostino, B. Dall’Oglio, R. Falabella, M. Falsaperla, M. Finocchiaro,F. Gaboardi, A. Galfano, F. Gallo, F. Greco, L. Costantino, R. Nucciotti,M. Oderda, V. Pagliarulo, P. Parma, A.L. Pastore, G. Pini, A. Porreca,L. Pucci, M. Schenone, R. Schiavina, C. Sciorio, L. Spirito, A. Tafuri,C. Terrone, P. Umari, V. Varca, D. Veneziano, P. Verze, A. Volpe, S. Micali,L. Berti, S. Zaramella, A. Minervini (Modena)Introduction: COVID-19 outbreak represented an unprecedentedevent that led to a redefinition of health care systems worldwide.The impact of the emergency required a deviation of the care towardthe assistance to COVID-19 patients, with reduction of resources forelective activities, including surgery.We aim to report the decrease of urological surgical activity during thefirst weeks from the beginning of the pandemic, aiming to highlightthe prioritization we applied to select patients for surgery.Materials andmethods: Thirty-three urological units with physiciansaffiliated to the AGILE groupwere involved in a survey. Urologists wereasked to report the amount of surgical elective procedures week- by-week, from the beginning of the emergency to the following month.The type of surgery (oncologic, for urolithiasis, for benign prostateobstruction, other) was assessed as well.Results: The 33 hospitals involved in the study account, globally, for22,945 beds and are distributed in 13/20 Italian regions. Before theoutbreak, the involved urology units performed an overall amount of1,213 procedures per week, half of which were oncological.By the 20 of March, the amount of surgery declined by 78%. Lombardy,the first region with positive-cases, experienced a 94% reduction. Thedecrease in oncological and non- oncological surgical activity was35,9% and 89%, respectively. Amongnon-oncological procedures, stonesurgery declined by 35,9% as well, whereas BPH and minor urologicalprocedures completely dropped. Reassessing for surgical activity on20, April, a slight trend toward surgical restoration (+11%) started toappear.Conclusions: Italy, the country with the highest fatality rate fromCOVID-19, had experienced a sudden decline in surgical activity; bythe end of April, a current trend toward restoration of surgery startedto appear. Criteria for prioritization were consistent with an urgent/European Urology Open Science 20(S2) (2020); S31–S192S190emergent principle, with trauma, tumours and septic conditions beingthe ones prioritized. The Italian experience can be helpful for futuresurgical pre-planning in other countries or pandemic settings.SC349 Telemedicine during COVID-19 pandemic by atertiary referral neurourology centerG. Sampogna, L.G. Zanollo, L. Rizzato, A. Spinelli, E. Montanari,M. Spinelli (Milano)Introduction: At the beginning of 2020, the healthcare communitywas under pressure because of the Coronavirus disease 2019 (COVID-19). When we resumed our regular activity, we should face withsignificant limits: restricted access, patient distancing, avoidingcrowds, and patients’ willing to avoid hospitals. Therefore, westarted telemedicine for follow-up visits.The aim of this study was to report our workflow and initial resultsassociated with telemedicine by a tertiary referral neurourologycenter.Materials andmethods:We prospectively collected the data from ouradult patients with a planned visit for neurogenic bladder by ourcenter from March 9th to May 22nd, 2020. Our workflow startedwith a phone call to evaluate patients’ feasibility to undertaketelemedicine due to COVID-19 pandemic. If they accepted, we askedpatients to fill in an online, pseudonymous module. The first sectioncollected demographic characteristics. The second section analysedCOVID-19 testing and related signs and symptoms (S&S). The thirdsection investigated urinary S&S. We assessed urinary incontinencetrough the International Consultation of Incontinence Questionnaire –Short Form (ICIQ-SF). The fourth section screened for neurogenicbowel dysfunction (NBD)with the decision-makingMENTOR tool. Thefinal result corresponded to a “traffic light” system (green, yellow, orred) to determine need for treatment changes. The online platformwas delivered as a progressive web app to avoid installation and adaptautomatically to different systems. We asked patients to send usperformed blood tests, radiological imaging, and bladder/boweldiaries. After reviewing all patients’ documentation, we called againeach patient to discuss final indications.Results: We called 96 patients. Four cases declined telemedicine,while 95.8% patients – 66 men and 26 women – accepted this service.All of themaccomplished all telemedicine phaseswithout needing ourhelp. The median age was 43.5 years (range: 19–85). The neurogenicbladder etiology was the following: acquired spinal cord injury(n = 37), congenital malformations (n = 19), autoimmune (n = 14),peripheral neuropathy (n = 8), idiopathic (n = 7), and others (n = 7).As for COVID-19, 3.3% patients reported a negative nasopharyngealswab, while 17.4% cases referred potential S&S. Patients experiencedmacrohematuria (n = 9), renal colic (n = 9), difficulties with catheriza-tion (n = 17), and symptomatic urinary tract infections (n = 21). Themedian ICIQ-SF was 5 (range: 0–21). Based on MENTOR tool, weaddressed 31 patients (red = 22; yellow = 9) to our gastroenterologists.All patients received a final medical report via telemedicine.Conclusions: Our telemedicine workflow proved to be feasible andeffective. Both authors andmost patients advocated the prosecution ofthis service beyond the COVID-19 pandemic, reducing hospitalinfections, in-hospital injuries, waiting lists for urgencies and firstvisits, hospital management costs, and patients’ travels (specially incase of mobility-impaired people).European Urology Open Science 20(S2) (2020); S31–S192 S191

Surgical activity in the COVID-19 era. Trend of slowdown from a multicentre observational study

https://iris.uniroma1.it/bitstream/11573/1452255/1/Rocco_Surgical-activity_2020.pdf

Surgical activity in the COVID-19 era. Trend of slowdown from a multicentre observational study

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