The impact of COVID-19 pandemic in urology practice, assistance and residency training in a tertiary referral center in Brazil

The COVID-19 global pandemic has significantly impacted healthcare systems throughout the World and resources were reallocated to combat the pandemic. Urology practice was deeply affected, with most guidelines publishing recommendations to postpone most of elective surgeries (1). To this day, Brazil is the second most affected country with over 3.3 million people COVID-19 cases and over 107.000 deaths. Since the end of March, a partial lockdown has been conducted in most cities even in those without any cases or deaths yet, and, four months later, there is still a high number of daily new cases. Hospital de Clínicas de Porto Alegre is one of the largest in Brazil, doing over 49.000 surgeries in the last year and over 567.000 outpatient consultations. Our patients are 95% from the public healthcare system, receiving patients from all cities in our state, and 5% from private care, so we can consider our hospital a representative part of the public system. Our Urology department is one of the largest surgical departments at our hospital, performing over 5.000 surgeries every year and is responsible for over 30% of the urological high complexity surgeries in our region. This year, however, the state secretary of health designed our hospital as the main referral center for COVID-19 patients in our state. Therefore, all departments, including Urology, made a contingency plan to reallocate resources and postpone elective surgeries. This study aims to analyze the impact in urology practice through the variation in outpatient clinics, urodynamics exams, and surgeries during the pandemic months compared to the same period of previous years and its effect on residency training compared to regular years.