Mehmet Caglar Cakici, Ayberk Iplikci, Ozgur Efiloglu, Gokhan Atis, Asif Yildirim

COVID-19 pandemisinin ürolojik konsültasyonlara ve ürolojik cerrahiye akut etkisi

Amaç: Koronavirus hastalığı (COVID-19) üroloji dahil olmak üzere tüm uzmanlık dallarının klinik işleyişlerini büyük ölçüde etkilemiştir. Klinisyenler de bu ani gelişen kaotik süreçten belli oranlarda etkilenmiştir. Bu çalışmada, pandemi döneminin ülkemizdeki akut evresinde ürolojik konsültasyonlara ve ürolojik cerrahiye etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Hastanemiz lokal etik kurul onayı (22.07.2020 tarihli karar numarası: 2020/0458) alındıktan sonra bu retrospektif çalışma tasarlandı. Ülkemizde görülen ilk vakadan sonraki ilk 4 haftalık periyotta üçüncü basamak sağlık kuruluşu olan hastanemizde Üroloji kliniğine acil servisten ve diğer kliniklerden konsülte edilen hastalar (Grup 1) ile 2019 yılının aynı dönemindeki hastalar (Grup 2) retrospektif olarak tarandı. Hastaların demografik özellikleri, pandemiye özgün triyaj değerlendirmeleri, konsültasyon nedenleri ve sonuçları ayrıntılı olarak analiz edildi. Bulgular: Toplam 377 hastanın 123’ü (%32,6) Grup 1’de, 254’ü (%67,4) Grup 2’de idi. Haftalık konsültasyon sayılarında Grup 2’de benzer dağılım mevcutken, Grup 1’de ikinci ve üçüncü haftalarda istatistiksel anlamlı düşüş ve dördüncü haftada da artış gözlendi (p=0,025). Grup 1’de konsültasyonların 93’ü (%75,6) acil servis hastalarıyken Grup 2’de bu sayı 180 (70,9) idi (p=0,116). En sık ilk iki konsültasyon nedeni Grup 1’de üriner enfeksiyonlar ve ürolitiyazisken; Grup 2’de ürolitiyazis ve hematüri idi (p=0,027). Grup 1’de ürolojik cerrahi müdahale oranı %24,4 iken; grup 2’de %37,8 idi (p=0,010). Sonuç: COVID-19 salgınının klinisyenler için zorluğu kendileri ve hastalar için kontaminasyondan korunurken en uygun tedaviyi sağlamak arasında bir denge kurmak olmuştur. Üroloji pratiğinde bu denge, konsültasyonların cerrahi ile sonuçlanması oranında azalma olarak ortaya çıkmıştır.

Anahtar Kelimeler:

COVID-19, konsültasyon, korona virüs, pandemi, ürolojik cerrahi

Acute effect of COVID-19 pandemic on urological consultations and urological surgery

Objective: Coronavirus disease (COVID-19) has greatly affected the clinical functioning of all sub-specialties, including urology. Clinicians have also been affected by this sudden chaotic process to a certain extent. In this study, we aimed to evaluate the effect of pandemic period on urological consultations and urological surgery in the acute phase of our country. Material and Methods: This retrospective study was designed after the approval of our hospital’s local ethics committee (Approval Date/Number: 22.07.2020: 2020/0458) was obtained. In the first 4 weeks after the first case in our country, the data of the patients who were consulted to the Urology clinic from the emergency service and other clinics in our hospital, which is a tertiary healthcare facility (Group 1), and patients in the same period of 2019 (group 2) were retrospectively collected. The demographic characteristics of the patients, specific triage evaluations for the pandemic, reasons for consultation and results were analyzed in detail.Results: Of the total 377 patients, 123 (32.6%) were in Group 1, and 254 (67.4%) were in Group 2. While there was a similar distribution in the number of weekly consultations in group 2, a statistically significant decrease was observed in the second and third weeks in Group 1 and an increase in the fourth week (p = 0.025). While 93 (75.6%) of the consultations were emergency service patients in group 1, this number was 180 (70.9) in Group 2 (p = 0.116). The two most common reasons for consultation were urinary infections and urolithiasis in Group 1; urolithiasis and hematuria in Group 2 (p = 0.027). While the rate of urological surgical intervention was 24.4% in Group 1; it was 37.8% in Group 2 (p = 0.010). Conclusions: The difficulty for clinicians of the COVID-19 outbreak has been to strike a balance between providing the most appropriate treatment while avoiding contamination for themselves and their patients. This balance in urology practice has emerged as a decrease in the rate of consultations resulting in surgery.

Keywords:

Consultation, COVID-19, pandemic, urological surgery, coronavirus,

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