Current situation in Urology practice in Spain during the COVID-19 pandemia

INTRODUCTION: On 11th March 2020 the WHO declared COVID19 a global pandemic, a challenge previously unseen for sanitary systems, including the activity in Urology departments. MATERIAL AND METHODS: Web and PubMed search using the keywords "SARS-CoV-2", "COVID19", "COVID Urology", "COVID surgery", "consensus methods", "nominal group", "Delphi method". A narrative revision of the literature until the 20th May 2020, including articles and documents in English and Spanish. RESULTS: Medical practice in Spain has been forced to rapidly adapt to the pandemic, dedicating most of its material and human resources to the care of patients infected by SARS-CoV-2. This has meant a significant reduction of the routine practice in Urology, as in other medical specialities, limiting the medical attention to urgent and emergent cases. Programmed activity has been reserved for selected cases in which a delayed attention could compromise survival. Different scientific associations have made a significant effort to adapt their recommendations to the pandemic, prioritizing high-risk oncologic cases, and reducing the use of ventilators and hospital stays to the minimum. These restrictions must be dynamic, adapting to the de-escalating phases as the pondemic is more controlled, widening the range of services available. In this de-escalate there is an additional challenge, being the difficulty in generating quality scientific evidence. In order to obtain such evidence, consensus methods have been used, such as the nominal group technique or the Delphi method. CONCLUSIONS: The COVID19 pandemic has meant a complete disruption in the routine activity in Urology in Spain, with a need for prioritizing the attention of urgent and high-risk oncologic pathology. These restrictions must be progressively modified according to the de-escalating process in the general population.