Safety of urologic elective surgery in a Covid-hospital: our experience in Milan

Abstract Purpose To demonstrate safety of a new internal protocol for patients and health workers adopted for elective urologic surgical activity during COVID-19 pandemic.Methods From March 9 to April 24, 2020 we have retrospectively evaluated 62 patients who underwent elective surgery in the urology department of IRCCS Policlinico San Donato which became a COVID-hospital. We identified non-deferrable patients that needed to be treated within one month. All patients followed a dedicated pathway from the day-hospital till the discharge. Clinical data, nasopharyngeal swabs, chest X-ray, type of anaesthesia, surgical procedure and days of hospitalization were collected. All patients were interviewed 14 days after surgery to check any Covid-related complications.Results The population included 48 (77.42%) men and 14 (22.58%) women, aged between 17 and 88 years old. We performed sixty-four (64) preoperative screenings and two (2) patients were excluded. 47 (75.81%) patients underwent oncological procedures while 15 (24.19%) patients underwent non-oncological surgery. The average hospitalization time was 2.39±2.21 days.After at least 14 postoperative days (25.00±10.35 days), we interviewed all patients to check their conditions. No patients showed symptoms related to COVID-19, except for 2 (3.23%) who manifested coryza, 28 and 35 days after discharge respectively. Neither patients nor hospital workers developed COVID-19 infection.Conclusion The duration of pandemic period is undefined; therefore, our protocol could be considered a good model for every type of surgery and its application could ensure a continuous treatment for non-deferrable conditions, in a safe way for both the patients and health workers.