The impact of COVID-19 pandemic on urological emergencies: a single-center experience.

PURPOSE: COVID-19 pandemic represents a novel challenge for healthcare systems, and it affects even the daily urological practice. Italy was the first country after China to experience a lock-down period. Our objective is to determine whether, during the COVID-19 period, there has been any modification in urological emergencies. METHODS: we retrospectively reviewed urgent urological consultations requested by the Emergency Department (ED) of Padua University Hospital in the 36-day period between February 22nd and March 30th, 2020 and compared them to the prior year cases within a similar time frame (February 24th to March 31st, 2019). Pediatric population (age < 15 years); surgical complications and traumas were excluded to avoid confounding from the reduction of activities during the lockdown. The number of daily consultations, the number of invasive procedures performed and admissions were evaluated, together with the predictors of admission were identified through multivariate logistic regression models. RESULTS: The final sample resulted in 107 consultations performed in 2020 and 266 in 2019. A higher number of daily consultations was performed during 2019 (7.33 vs 2.97, p < 0.001). Similarly, the number of daily-invasive procedures was higher in 2019 (p = 0.006), while there was no difference in the number of daily admissions (15 vs 12, p = 0.80). On multivariate analysis, the year (2020 vs 2019, OR 2.714, 95% CI 1.096-6.757, p = 0.0297) was a significant predictor of admission. CONCLUSIONS: Urgent urology practice was affected during COVID-19 pandemic with a remarkable reduction in urgent urological consultations; furthermore, a higher risk of admissions was observed in 2020. The consequences of a potentially delayed diagnosis remain to be determined.

Holmium laser enucleation of the prostate with transurethral intraprostatic anesthesia using Schelin catheter: a preliminary communication.

Introduction: This study was aimed to evaluate the feasibility, safety, and advantages of the use of transurethral intraprostatic anesthesia (TUIA) using Schelin CatheterTM (SC) in patients undergoing holmium laser enucleation of the prostate (HoLEP). Material and methods: TUIA was performed using SC, a catheter equipped with an operative channel with a retractile needle, a standard drainage outlet, and a balloon port. After inserting the SC into the patient's urethra and filling the balloon to anchor it in the bladder neck, four target injections with local anesthetic were performed, one in each quadrant in the base area of the prostate. After injections, the catheter was removed and the HoLEP procedure started. During the procedure, patients also received moderate sedation/analgesia. Results: We selected two 63-year-old patients with good performance status. Prostate volume was 40 ml for the first patient and 31 ml for the second. TUIA and HoLEP operative times were 68 minutes in the first patient and 42 minutes in the second.During the procedure, patients complained of only minimal discomfort, and during hospitalization patients' numeric rating scale (NRS) pain score ranging from 1 to 0, with no need for additional analgesics. No complications were reported perioperatively and 15 days after the procedure. Conclusions: This is the first report on TUIA via SC in patients undergoing HoLEP. In our preliminary experience, TUIA via SC was safe and feasible, showing complete perioperative pain control. Further studies are needed to confirm these promising results and better define the category of patients eligible for this type of treatment.