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BACKGROUND:
Urologic consultation is an essential service provided by urology divisions. We examined urology call coverage diagnoses, acuity and management in our institution.
METHODS:
Data was prospectively collected for urologic consultations in a 3 month period. Patient’s age, location, diagnosis, level of acuity, encounter time, and management was recorded. Eight attendings, three residents and one PA provided coverage.
RESULTS:
869 encounters were recorded, and 857 had analyzable data. Average age was 60.1 years old. There were 85 pediatric calls (10%). Urgent encounters involved 19% of patients; 81% were considered elective. Stones, infection and urinary retention were the most common diagnoses (See Table 1). 93% of encounters involved patients at our institution or the urology practice.

Distribution of diagnoses

Retention	12%
Neoplasm	10%
Other	9%
Hematuria	8%
Pain	8%
Medication question	7%
Missing data	6%
Surgery related question	4%
Obstruction	4%
Hydronephrosis	3%

Of 857 encounters, 180 (21%) required patient contact and 677 (79%) were managed over the telephone. Average phone call was 8 minutes, and 569 (84%) calls were under 10 minutes. Face-to-face encounters lasted 43 minutes on average.
Procedures were needed in 63 (35%) encounters: bladder catheterization 27 (43%), transurethral surgery 20(32%) , cystourethroscopy 16 (25%). Management of these procedures was split between inpatient floor 32 (51%) and operating room 31 (49%).
CONCLUSIONS:
These data show the majority of consults involve common non-emergent conditions, usually manageable over the telephone in a reasonable period of time. Clinical data describing the experience “on-call” informs residency curriculum development and hospital urologic coverage needs.