Findings of a Simple Institutional Screening Method in Ambulatory Pediatric Urology Procedures Amidst COVID-19 Surges in Iran

Abstract

Background: The COVID-19 pandemic significantly affected global healthcare, particularly affecting surgical practices. During the initial stages, there was a widespread suspension of elective surgeries, which posed challenges to surgical care centers. Protocols were developed to resume surgical activities, but the risk of perioperative infections persisted. Pediatric urology faced unique challenges due to the lack of consensus on preoperative screening for ambulatory surgical centers. Objectives: The present study aimed to assess the efficacy of a simple institutional preoperative screening method for adverse outcomes in pediatric ambulatory urology procedures during the pandemic. A retrospective review of medical records from an outpatient ambulatory surgery center was conducted for this purpose. Methods: This retrospective cross-sectional study analyzed the effectiveness of an institutional preoperative screening method in reducing the incidence of symptomatic viral infections and non-surgical complications during six distinct pandemic peaks in pediatric urology surgery in Iran (February 2020 to March 2023). Results: Of the 825 patients, most were male (758 males vs. 67 females), with an average age of 27.7 ± 30.0 months. Elective surgery cancellations were low (2.4%), primarily due to fever, cough, and elevated inflammatory markers. Polymerase chain reaction (PCR) tests were positive in 0.24% of symptomatic patients, none of whom developed postoperative COVID-19. There were significant correlations between symptomatic patients and cancellations during COVID-19 peaks (P = 0.035). Conclusions: A combination of clinical and laboratory examinations may suffice for preoperative screening of pediatric urology surgical procedures during the pandemic. Routine PCR testing is not recommended in this setting and should be confined to symptomatic patients. Moreover, the reported experience may be useful in addressing potential future viral outbreaks.