ABSTRACT
Objectives: We aimed to reveal how four different areas that are important in the functioning of the urology clinic (outpatient clinic, inpatient clinic, operating room, and consultations) were affected during the COVID-19 pandemic. Method(s): Patients admitted to the surgical branches between March 11, 2018 and March 10, 2021 were retrospectively evaluated in terms of their demographic data. The data between these dates were analyzed by dividing the patients into three groups as Groups A, B, and C for the pandemic period, the year before the pandemic, and two years before the pandemic, respectively. Result(s): A total of 1,222,967 patients were included in the study. During the pandemic period, the number of urology outpatient clinic admissions decreased by more than half compared to the previous years (37,471, 93,582, and 89,031 for Groups A, B, and C, respectively). Admissions to the urology inpatient clinic decreased both numerically and proportionally when compared to the other surgical branches (1,301 [5.1%] for Group A, 3,884 [7.7%] for Group B, and 3,761 [7.7%] for Group C]). While the mortality rate did not change proportionally in the urology clinic in all groups (0.3%), it increased both numerically and proportionally in all surgical branches (339 [1.3%], 304 [0.6%], and 256 [0.5%]). Conclusion(s): Admissions to the urology clinic were determined to have decreased during the pandemic compared to the pre-pandemic period, especially due to restriction measures taken by countries and concerns about the unknowns of the disease. As a result of this decrease, the number of operations and the number of hospitalized patients were also reduced. Although the mortality rate was not affected in the short-term followup of patients, long-term outcomes remain uncertain. ©Copyright © 2022 by Prusa Medical Publishing.
ABSTRACT
Introduction &Objective: Performing holmium laser enucleation of the prostate (HoLEP) as a same day surgery is a safe and feasible option for the majority of patients. Shortening postoperative hospital stays can minimize patient burden and increase accessibility to surgical care. We present our experience of 155 patients who underwent HoLEP during the pandemic last year. Admissions were limited to patients that required continuous bladder irrigation given the limited surgical bed availability and other restrictions imposed by the Covid-19 pandemic. Method(s): From January 2021 till January 2022, 155 patients have undergone HoLEP surgery in which 135 were discharged on the same day and 20 patients were admitted. Perioperative data were retrospectively collected, and postoperative outcomes at least 2 months after the surgery were evaluated in terms of safety and efficacy and compared in both groups using chi-square and t-test. Multivariable logistic regression was also performed to identify factors associated with postoperative complications. Result(s): The mean age of the same day discharge group (n = 135) is 71.2 (SD = 7.1). The mean prostate specific antigen(ng/dL) and prostate volume(mL) in the same-day discharge group were 5.3 (range 0.16-48.4) and 112.6 (range 52-350), respectively, with 3.7% readmission rate and 9.6% emergency department visit rate. Our same-day discharge rate was 87% of the total patients. Prostate Specific Antigen (P =.001), prostate volume (P <.001), and enucleated tissue weight (P =.04) were significantly higher in the admitted group. There was no difference in the rate of postoperative emergency department visits (P =.80), readmissions (P = 1), postoperative complications, and catheterization time (P =.98) between both groups. Patients using blood thinners had 3.35 (95% CI: 1.24-9.08) greater odds of having postoperative complications. Conclusion(s): Same-day discharge following HoLEP is a safe and effective approach in most patients without an increase in postoperative complications.