Comparative Assessment of Urological Emergency Cases Before and After the COVID-19 Outbreak

Year 2025, Volume: 78 Issue: 2, 128 - 136, 01.07.2025

Selçuk Sarıkaya , İbrahim Kılıççalan Selim Can Peker , Selahattin Bedir

Abstract

Objectives: Coronavirus disease-2019 (COVID-19) pandemic originated from China and has affected all countries in the world as well as Türkiye. In our study, we aimed to evaluate the effects of COVID-19 pandemic on urological emergency admissions.

Materials and Methods: Urological emergency admissions between March 2019-February 2020 and March 2020-February 2021 periods were noted and evaluated in detail. The admissions were divided into two groups as non-traumatic and traumatic admissions for both periods. Traumatic and non-traumatic admissions were analyzed in detail and statistical analysis was performed in order to analyse the differences in terms of admission type and gender.

Results: Two thousand two hundred fifty-two cases were evaluated (1,096 before the pandemic, 1,156 after the pandemic). The renal traumas, ureteral traumas, bladder traumas, penile traumas, scrotal traumas, simultaneous penile and scrotal traumas and other trauma types were evaluated in detail. Non-traumatic urological emergencies were also investigated for the same time periods. Testicular torsions, acute scrotum, urinary tract infections, fournier gangrenes, hematuria, urolithiasis, glob vesicale, pregnants with urological complaints, priapism and other urological conditions were seen and evaluated in detail. Statistically significant difference has been observed between the periods.

Conclusion: Emergency admissions have been affected by the COVID-19 pandemic. The deferred complaints changed the emergency admission conditions. Most of the people delayed their routine outpatient clinic follow-ups or their first admissions due to the disease transmission concerns. These factors have resulted in changes and mostly caused late diagnosis and treatment.

Keywords

COVID-19 , pandemic , outbreak , urological emergency , emergency

Ethical Statement

The ethical approval was obtained from the Committee on the Scientific Research Ethics of the University of Health Sciences Türkiye, Gülhane Faculty of Medicine (date: 03.06.2021, number: 2021/11).

Supporting Institution

-

Project Number

-

Thanks

-

COVID-19 Pandemisi Öncesi ve Sonrası Ürolojik Acil Olguların Karşılaştırmalı Değerlendirmesi

Abstract

Amaç: Çin kaynaklı koronavirüs hastalığı-2019 (COVID-19) pandemisi, Türkiye’nin yanı sıra tüm dünya ülkelerini etkisi altına aldı. Çalışmamızda COVID-19 salgınının ürolojik acil başvurulara etkilerini değerlendirmeyi amaçladık.

Gereç ve Yöntem: Mart 2019-Şubat 2020 ve Mart 2020-Şubat 2021 dönemleri arasındaki ürolojik acil başvuruları kayıt edilerek detaylı olarak değerlendirildi. Başvurular her iki dönem için de travmatik ve travmatik olmayan başvurular olarak iki gruba ayrıldı. Travmatik ve travmatik olmayan başvurular ayrıntılı olarak incelendi ve istatistiksel analiz yapıldı. İstatistiksel analiz, başvuru nedenlerine ve cinsiyete göre farklılıkları ortaya koymak için yapıldı.

Bulgular: İki bin iki yüz elli olgu değerlendirildi (pandemiden önce 1096, pandemiden sonra 1156). Böbrek travmaları, üreter travmaları, mesane travmaları, penis travmaları, skrotal travmalar, eş zamanlı penil ve skrotal travmalar ve diğer travma türleri detaylı olarak değerlendirildi. Aynı zaman dilimlerinde travmatik olmayan ürolojik aciller de araştırıldı. Testis torsiyonları, akut skrotum, idrar yolu enfeksiyonları, fournier gangren, hematüri, ürolitiazis, glob vesikale, ürolojik şikayeti olan gebeler, priapizm ve diğer ürolojik patolojiler detaylı olarak değerlendirildi. Dönemler
arasında istatistiksel olarak anlamlı farklılıklar gözlenmiştir.

Sonuç: Acil servis başvuruları COVID-19 salgınından etkilendi ve ertelenen şikayetler acil başvurularını değiştirdi. Çoğu kişi hastalık bulaşma endişesi nedeniyle rutin poliklinik takiplerini ya da ilk başvurularını erteledi. Ertelenen başvurular çoğunlukla geç tanı ve tedaviye neden olmuştur.

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

• 1. Pollard CA, Morran MP, Nestor-Kalinoski AL. The COVID-19 pandemic: a global health crisis. Physiol Genomics. 2020;52:549-557.
• 2. Ludvigson AE, Beaule LT. Urologic emergencies. Surg Clin North Am. 2016;96:407-424.
• 3. Bašković M, Čizmić A, Bastić M, Župančić B. The impact of the COVID-19 pandemic on the most common diagnoses in pediatric surgery: abdominal pain, acute scrotum, upper and lower extremity ınjuries tertiary center experience. Turk Arch Pediatr. 2021;57:38-45.
• 4. Motterle G, Morlacco A, Iafrate M, et al. The impact of COVID-19 pandemic on urological emergencies: a single-center experience. World J Urol. 2021;39:1985-1989.
• 5. Grasso AAC, Massa G, Castelnuovo M. the ımpact of COVID-19 pandemic on urological emergencies: a multicenter experience on over 3,000 patients. Urol Int. 2021;105:17-20.
• 6. Erlich T, Kitrey ND. Renal trauma: the current best practice. Ther Adv Urol 2018;10:295-303.
• 7. Chouhan JD, Winer AG, Johnson C, Weiss JP, Hyacinthe LM. Contemporary evaluation and management of renal trauma. Can J Urol. 2016;23:8191- 8197.
• 8. Engelsgjerd JS, LaGrange CA. Ureteral injury. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
• 9. Siram SM, Gerald SZ, Greene WR, et al. Ureteral trauma: patterns and mechanisms of injury of an uncommon condition. Am J Surg. 2010;199:566- 570.
• 10. Mahat Y, Leong JY, Chung PH. A contemporary review of adult bladder trauma. J Inj Violence Res. 2019;11:101-106.
• 11. Kang L, Geube A. Bladder trauma. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
• 12. Simon LV, Sajjad H, Lopez RA, Burns B. Bladder rupture. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
• 13. Cozzi D, Verrone GB, Agostini S, et al. Acute penile trauma: imaging featuresin the emergency setting. Radiol Med. 2019;124:1270-1280.
• 14. Keays M, Rosenberg H. Testicular torsion. CMAJ. 2019;191:E792.
• 15. Sharp VJ, Kieran K, Arlen AM. Testicular torsion: diagnosis, evaluation, and management. Am Fam Physician. 2013;88:835-840.
• 16. Norton SM, Considine S, Dowling C, D’Arcy F. Where are the paediatric patients with testicular torsion during the COVID-19 pandemic? Ir J Med Sci. 2022;191:2423-2426.
• 17. Littman AR, Janssen KM, Tong L, et al. Did COVID-19 affect time to presentation in the setting of pediatric testicular torsion? Pediatr Emerg Care. 2021;37:123-125.
• 18. Günther P, Rübben I. The acute scrotum in childhood and adolescence. Dtsch Arztebl Int. 2012;109:449-457;quiz 458.
• 19. Foxman B. The epidemiology of urinary tract infection. Nat Rev Urol. 2010;7:653-660.
• 20. Kuitunen I, Artama M, Haapanen M, Renko M. Urinary tract infections decreased in Finnish children during the COVID-19 pandemic. Eur J Pediatr. 2022;181:1979-1984.
• 21. Hatoun J, Correa ET, Donahue SMA, Vernacchio L. Social distancing for COVID-19 and diagnoses of other ınfectious diseases in children. Pediatrics. 2020;146:e2020006460.
• 22. Liguoro I, Pilotto C, Vergine M, Pusiol A, Vidal E, Cogo P. The impact of COVID-19 on a tertiary care pediatric emergency department. Eur J Pediatr. 2021;180:1497-1504.
• 23. Bağcioğlu M, Kayiş A. Fournier gangreni. Türkiye Klinikleri J Urology-Special Topics. 2017;10:321-328.
• 24. Thwaini A, Khan A, Malik A, et al. Fournier’s gangrene and its emergency management. Postgrad Med J. 2006;82:516-519.
• 25. Gülşen T, Sücüllü İ, Balta AZ, Demir M, Kurt Y. Fournier’s gangrene. Turk J Colorectal Dis. 2019;29:206-210.
• 26. Paty R, Smith AD. Gangrene and Fournier’s gangrene. Urol Clin North Am. 1992;19:149-162.
• 27. Avellino GJ, Bose S, Wang DS. Diagnosis and management of hematuria. Surg Clin North Am. 2016;96:503-515.
• 28. Knoll T. Epidemiology, pathogenesis, and pathophysiology of urolithiasis. European Urology Supplements. 2010;9:802-806.
• 29. Daudon M, Doré J-C, Jungers P, Lacour B. Changes in stone composition according to age and gender of patients: a multivariate epidemiological approach. Urol Res. 2004;32:241-247.
• 30. Thakore P, Liang TH. Urolithiasis. StatPearls, Treasure Island (FL): StatPearls Publishing; 2022.
• 31. Moran CP, Courtney AE. Managing acute and chronic renal stone disease. Practitioner. 2016;260:17-20, 2-3.
• 32. Serlin DC, Heidelbaugh JJ, Stoffel JT. Urinary retention in adults: evaluation and initial management. Am Fam Physician. 2018;98:496-503.
• 33. Billet M, Windsor TA. Urinary retention. Emerg Med Clin North Am. 2019;37:649-660.
• 34. Gelber J, Singh A. Management of acute urinary retention in the emergency department. Emerg Med Pract. 2021;23:1-28.
• 35. Mavrotas J, Gandhi A, Kalogianni V, Patel V, Batura D. Acute urinary retention. Br J Hosp Med (Lond). 2022;83:1-8.
• 36. Patel K, Batura D. An overview of hydronephrosis in adults. Br J Hosp Med (Lond). 2020;81:1-8.
• 37. McConnell JD, Barry MJ, Bruskewitz RC. Benign prostatic hyperplasia: diagnosis and treatment. Agency for Health Care Policy and Research Clin Pract Guidel Quick Ref Guide Clin. 1994:1-17.
• 38. Krajewski W, Wojciechowska J, Dembowski J, Zdrojowy R, Szydełko T. Hydronephrosis in the course of ureteropelvic junction obstruction: An underestimated problem? Current opinions on the pathogenesis, diagnosis and treatment. Adv Clin Exp Med. 2017;26:857-864.
• 39. Pedro RN, Das K, Buchholz N. Urolithiasis in pregnancy. Int J Surg. 2016;36:688-692.
• 40. Grosjean J, Cannie M, de Meyer J-M. [Physiological hydronephrosis in pregnancy: Occurrence and possible causes. An MRI study]. Prog Urol. 2017;27:603-608.
• 41. Giusti G, Proietti S, Peschechera R, et al. Sky is no limit for ureteroscopy: extending the indications and special circumstances. World J Urol. 2015;33:257-273.
• 42. Carnicelli D, Akakpo W. Priapism: Diagnosis and management. Prog Urol. 2018;28:772-776.
• 43. Ericson C, Baird B, Broderick GA. Management of priapism: 2021 update. Urol Clin North Am. 2021;48:565-576.
• 44. Salonia A, Eardley I, Giuliano F, et al. European association of urology guidelines on priapism. Eur Urol. 2014;65:480-489.