• Aoibhinn McDermott, John O'Kelly, Mark Jack Quinlan, Dilly M Little, and Niall Francis Davis.
• Department of Urology, Beaumont Hospital, Dublin, Ireland.
• Ir J Med Sci. 2021 Aug 1; 190 (3): 919-923.

BackgroundThe risk of acquiring perioperative SARS-CoV-2 infection is concerning for surgeons and patients.AimsIn this study, we investigate the incidence of postponed, medically necessary, time-sensitive urological procedures due to a patient's unwillingness to proceed to a recommended surgical intervention during the first phase of the SARS-CoV-2 pandemic.MethodsWe prospectively monitored all patients undergoing elective urological surgery during the initial phase of the SARS-CoV-2 pandemic. The primary outcome measurement was incidence of postponed, medically necessary, urological procedures due to the patient's decision not to proceed to a recommended urological intervention (16th of March-5th of June 2020). The secondary outcome measurements were the type of delayed procedure and duration of postponement.ResultsDuring the initial 12-week period of the SARS-CoV-2 pandemic, 155 elective urgent urological procedures were scheduled after pre-operative SARS-CoV-2 screening. In total, 140 procedures were performed and 15 (10%) patients intentionally delayed their urological procedure due to the perceived risk of acquiring nosocomial perioperative SARS-CoV-2 infection. The duration for procedural delays is currently 42 ± 23 (range: 15-80) days. The most frequently postponed procedures among patients unwilling to proceed to surgery are urgent endourological procedures due to symptomatic urolithiasis (n = 7/15).ConclusionsThe incidence for patients postponing urological procedures due to the risk of acquiring nosocomial SARS-CoV-2 is 10%. Endourological procedures for urolithiasis are the most frequently postponed procedures by patients. This study demonstrates that a subset of patients will decline urgent urological surgery during the SARS-CoV-2 pandemic.© 2020. Royal Academy of Medicine in Ireland.

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