How did the first year of the COVID-19 pandemic affect urology practice in Arab countries? A cross-sectional study by the Arab Association of Urology research group

Yasser A Noureldin 1, Basheer Elmohamady 2, Amr S El-Dakhakhny 2, Mohamed Omar 3, Esam E A Desoky 4, Yahia Ghazwani 5, Saeed Bin Hamri 5, Abdullah Alkhayal 5, Khalid Alrabeeah 5, Wissam Kamal 6, Fawzy Farag 7, Yasser Farahat 8

Affiliations

doi: 10.1177/17562872221079492

Abstract

Objective: The aim of this study was to assess of the effect of coronavirus disease 2019 (COVID-19) pandemic on urology practice in the Arab world during the first year of the crisis.

Methods: An Internet-based questionnaire was created and sent out via email to members of the Arab Association of Urology (AAU) using 'Google Forms'. The survey assessed participants' demographics in terms of age, gender, country of origin, type of practice and position. Impacts of COVID-19 on urological practice were assessed in terms of the changes in hospital policies regarding consultations, and elective and emergency surgical cases. Moreover, impacts of COVID-19 on urologists were assessed.

Results: A total of 255 AAU members across 14 Arab countries (Emirates, Egypt, Saudi Arabia, Iraq, Jordan, Algeria, Kuwait, Yemen, Qatar, Lebanon, Libya, Oman, Sudan and Syria) completed the survey; 4% were female urologists. Consultations at outpatient clinics were closed or restricted to emergency cases or replaced by telemedicine in almost 15%, 40% and 25% of hospitals, respectively. Elective surgeries were stopped or reduced to under 25% of surgical capacity in >10% and about 25% of hospitals, respectively. Almost 90% (228) reported changes in the policy for emergency theatres. Nearly 65% of hospitals offered preoperative COVID-19 testing to patients and 50% of hospitals provided personal protective equipment (PPE) to their urologists. Of 99% (253) who reported a change in urological education, 95% relied on online webinars. About 56% of respondents had their own private practice, of whom 91% continued private practice during the crisis. About 38% of participants reported exposure to intimidation (75% emotional, 20% verbal and 5% physical).

Conclusion: The COVID-19 pandemic resulted in major changes in hospitals' policies regarding outpatient consultations, elective and emergency operative cases, and the shift to telemedicine. Arab urologists have been facing major challenges either in both the governmental or the private sectors, and some of them were exposed to emotional, verbal and even physical intimidation.

Keywords: Arab; COVID-19; effect; practice; urology.

Conflict of interest statement

Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1. The triage policy for eight common urological operations in terms of the priority for performing these operations during the first year of COVID-19 and the percentage of respondents for each operation. TURBT, transurethral resection of bladder tumour; TURP, transurethral resection of the prostate. *Priority was reported on a scale from 0 = not done, 1 = very low priority, 2 = low priority, 3 = intermediate priority, 4 = high priority and 5 = very high priority.

Figure 1. The triage policy for eight common urological operations in terms of the priority for performing these operations during the first year of COVID-19 and the percentage of respondents for each operation. TURBT, transurethral resection of bladder tumour; TURP, transurethral resection of the prostate. *Priority was reported on a scale from 0 = not done, 1 = very low priority, 2 = low priority, 3 = intermediate priority, 4 = high priority and 5 = very high priority.

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