Organization of urological care in Ukraine: directions for improvement

Purpose: to investigate the state of the organization of urological care for the population of Ukraine before the full-scale invasion and under wartime conditions; determine areas of improvement.

Object of study: the system of organizing urological care for the population.

Subject of study: legislative regulation, network of institutions, personnel, financial and technological support of urological care; the state of implementation of modern innovative medical and diagnostic technologies in urological practice.

Research methods: content analysis; medical and statistical; bibliosemantic; generalization.

Results. It is shown that a certain decrease in the prevalence and incidence of diseases of the genitourinary system occurred in 2008–2017. However, the contingent of patients with diseases of the genitourinary system was stable at about 4 million people. Injuries to the organs of the genitourinary system make up 3.5% of the structure of combat injuries. The network of urological offices of polyclinics decreased by 26.9%, urological profile beds decreased by 37.3% during 2013–2022. The redistribution of urological beds took place between regional, city, central district and district hospitals, hospitals for war invalids: in 2013, the ratio was 1:2,6:1,2:0,2, respectively, and in 2022 — 1:1, 8:0.6:0.12. The number of urologists decreased by 19.3% over 10 years, the staffing of full-time positions by individuals of these doctors decreased from 90.54% to 86.48%, in particular, in polyclinic institutions — from 90.9% to 81.71%. Modern medical and diagnostic technologies — simultaneous and multidisciplinary approaches, minimally invasive intrarenal approaches — are introduced into urological practice. At the same time іndustry technologies based on evidence-based clinical data are insufficiently developed. The contribution of primary medical care to the prevention of diseases of the genitourinary system, timely detection of urological pathology, long-term rehabilitation and medical observation of patients in outpatient settings is limited.

Conclusion. The directions for improving the organization of medical care for patients with diseases of the genitourinary system are to preserve the personnel of the urological service, ensure the quality of urological care by developing industry unified clinical protocols, integrating urological care into primary care institutions, and more actively using ambulatory surgery.