Global change of surgical and oncological clinical practice in urology during early COVID-19 pandemic

Category	Detail
Condition	Impact of COVID-19 pandemic on urological surgical and oncological practices
Key Mechanisms	Reallocation of healthcare resources, prioritization and down-escalation of surgeries, balancing cancer progression risk against COVID-19 infection risk
Target Population	Urologic oncologists and urologic surgeons managing patients requiring surgical and oncological care
Care Setting	Hospital-based urology departments globally, including public and private institutions

93% of surveyed urologists reported changes in clinical practice due to COVID-19.
Surgical activity was down-escalated in stages, with 13% performing emergency cases only.
Delays in cancer surgeries, such as cystectomy beyond 3 months, are linked to worse survival outcomes.

Assess COVID-19 risk status of the region and hospital to inform clinical decision-making.

Implement step-wise down-escalation of surgical procedures prioritizing urgent and emergency cases.
Suspend elective surgeries to preserve intensive care and staff resources for COVID-19 patients.
Balance risks of cancer progression against potential COVID-19 exposure when considering (neo)adjuvant and palliative treatments.

Monitor local COVID-19 infection rates and hospital capacity to adjust surgical prioritization accordingly.
Track timing of surgery delays to minimize adverse oncological outcomes.

Delaying cancer surgeries may increase disease-specific and overall mortality.
Healthcare resource constraints may limit availability of intensive care for surgical patients.
Risk of COVID-19 infection among patients and healthcare professionals in urology departments.

Patients requiring urological oncological surgeries and systemic treatments during the COVID-19 pandemic

Decisions on initiating (neo)adjuvant or palliative systemic treatments should consider COVID-19 exposure risk and healthcare resource availability.

Use a staged approach to prioritize urological surgeries based on urgency and resource availability.
Provide COVID-19 training for medical staff involved in urological care.
Involve staff in COVID-19 patient care planning to optimize resource allocation.
Utilize global and regional data to benchmark and forecast changes in urological practice during the pandemic.

Clinical Scorecard: Transformations in Urological Surgical and Oncological Practices During the Initial Phase of the COVID-19 Pandemic