Impact of COVID-19 on Urology Services at a Quaternary Referral Center in Johannesburg, South Africa

Background South Africa was placed into a nationwide lockdown on March 26, 2020, to limit the transmission of severe acute respiratory syndrome coronavirus 2. Medical facilities were overwhelmed, and the redeployment of medical staff to deal with coronavirus disease 2019 (COVID-19) cases resulted in the disruption of typical urology services. This has led to the reprioritization of care for urology patients with delays in all elective cases. Materials and methods In this retrospective study, we compared the numbers and types of patients seen in our urology outpatient clinics, ward admissions, and theater cases 90 days before and after the first COVID-19 lockdown. The changes in numbers were calculated as percentages, and Fisher exact test was used to determine p values. Results The number of patients in urology outpatient clinics significantly declined (26.4%) after the lockdown started. Outpatient procedures, which were mostly diagnostic, decreased by 28.6%, with no change observed in therapeutic procedures. A decrease in the total number of theater cases (37.4%) and ward admissions (45.0%) was also observed after the lockdown because of a decrease in elective cases, although the number of emergency and oncology patients was relatively stable. Conclusions Coronavirus disease 2019 and the lockdown forced the urology department to shift the focus to only emergency and oncology cases. This resulted in delays in the treatment of benign elective conditions and a subsequent increase in the backlog of pending surgeries for these conditions, which could potentially lead to future complications. Although COVID-19 is a major problem requiring many resources, ensuring that urological patients still receive adequate care and management is also important.