Description:
<jats:sec><jats:title>Objectives</jats:title><jats:p>To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic (VC) strategies, and to highlight research gaps in this rapidly evolving field.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Our PROSPERO‐registered (CRD42019151946) systematic search of Embase, Medline and the Cochrane Review Database was performed to identify original research articles pertaining to adult urology telehealth or VC strategies. Risk‐of‐bias (RoB) assessment was performed according to the Cochrane 2.0 RoB tool or the Joanna Briggs Institute Checklist for non‐randomized studies.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 5813 participants were included from 18 original articles (two randomized controlled trials [RCTs], 10 prospective studies, six retrospective studies). Urology sub‐specialities comprised: uro‐oncology (<jats:italic>n</jats:italic>= 6); general urology (<jats:italic>n</jats:italic>= 8); endo‐urology (<jats:italic>n</jats:italic>= 2); and lower urinary tract symptoms and/or incontinence (<jats:italic>n</jats:italic>= 2). Across all sub‐specialties, prospective studies using VCs reported a primary median (interquartile range [IQR]) VC discharge rate of 16.6 (14.7–29.8)% and a primary median (IQR) face‐to‐face (FTF) clinic referral rate of 32.4 (15.5–53.3)%. Direct cost analysis demonstrated median (IQR) annual cost savings of £56 232 (£46 260–£61 116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with rates of 0.20% (3/1534) and 0.13% (2/1534), respectively. The annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO<jats:sub>2</jats:sub>emissions, depending on the mode of transport used. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Urology VCs are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological sub‐specialties to confirm equivalency and safety against traditional FTF assessment.</jats:p></jats:sec>