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Ye Z, Chen H, Liu X, Wei G. Delayed Care Seeking and Outcomes of Testicular Torsion among Children during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Eur J Pediatr Surg 2023; 33:377-385. [PMID: 36384233 DOI: 10.1055/s-0042-1758153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Since the onset of coronavirus disease 2019 (COVID-19), stay-at-home orders and fear caused by the pandemic have had a significant effect on the timing and outcomes of testicular torsion. However, the evidence was limited since the study results were inconsistent. This study aims to examine the hospitalization rates, timing, and outcomes of testicular torsion in children before and during the pandemic. MATERIALS AND METHODS Using PubMed, Embase, and Google Scholar databases, we conducted a systematic search and meta-analysis of studies reporting the timing and outcomes of children admitted with testicular torsion before and during the COVID-19 pandemic. Subgroup analyses were conducted to explore possible sources of heterogeneity. RESULT The outcomes of 899 testicular torsion patients from eight studies were evaluated. Our study found an increased hospitalization rate for patients with testicular torsion (incidence rate ratio = 1.60, 95% confidence interval [CI]: 1.27-2.03; p = 0.001). Despite a significant increase in the duration of symptoms during the COVID-19 pandemic (weighted mean difference = 11.04, 95% CI: 2.75-19.33; p = 0.009), orchiectomy rates did not increase (odds ratio = 1.33, 95% CI: 0.85-2.10; p = 0.147). CONCLUSION During the COVID-19 pandemic, hospitalization rates for testicular torsion and the duration of symptoms among children increased significantly. Moreover, the rate of orchiectomy did not increase during the pandemic, indicating that pediatric emergency services have remained efficient and have prevented an increase in the number of orchiectomies performed despite pandemic-related closures and delays in transporting patients to medical care.
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Affiliation(s)
- Zihan Ye
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Hongsong Chen
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Xing Liu
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Guanghui Wei
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
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Impact of COVID-19 on urology services at a quaternary referral center in Johannesburg, South Africa. Curr Urol 2022. [DOI: 10.1097/cu9.0000000000000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Georgiou M, Ridzuan-Allen A, Chamsin A, Siddiqui Z, Tolofari S, Ejikeme C, Jones R, Napier-Hemy TP, Rotas S, Hughes KE, Khattak AQ, McCabe JE, Omar AM, Mistry R, Samsudin A, Gana HBY, Floyd MS. Emergency Urology procedures during the COVID-19 pandemic in the UK: A 3-month prospective study. Urologia 2022:3915603221136321. [PMID: 36346172 PMCID: PMC9646888 DOI: 10.1177/03915603221136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency surgical care. Specific to Merseyside, Tier 4, Tier 2 and Tier 5 restrictions were introduced in late 2020 and early 2021. The purpose of this study was to examine the nature and workload of emergency urological procedures during three different national lockdown Tiers in the North West of England. METHOD A 3-month prospective study examining all emergency urological activity was conducted from November 2020 when Tier 4 restrictions were introduced and included Tier 2 restrictions in December and then concluded at the end of January 2021 when Tier 5 restrictions were in place. Data was obtained by identifying patients using the electronic theatre listing system. RESULTS A total of 71 emergency cases were performed (24 in November (Tier 4), 28 in December (Tier 2), 19 in January 2021 (Tier 5)) with 15 different types of procedures performed. The most frequently performed procedure was stent insertion (36), followed by scrotal exploration (10). The least commonly performed procedure was suprapubic catheter insertion under general anaesthesia (1). One patient required transfer to a different hospital. In total 6 calls were made by general surgery and 3 by gynaecology for urgent urological assistance in theatre. Three urology patients returned to the theatre as emergencies following elective procedures. CONCLUSION Unlike the Spring lockdown, acute urological presentations requiring operative intervention still presented daily. Of the 71 cases performed, most occurred in Tier 2. Stent insertion was the most commonly performed procedure, with the majority of the cases performed by registrars.
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Affiliation(s)
- Marita Georgiou
- Marita Georgiou, Department of Urology, St
Helens and Knowsley NHS Trust, Whiston Hospital, Prescot L35 5DR, Merseyside,
UK.
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Scotland K, Tailly T, Chew BH, Bhojani N, Smith RD. Consensus Statement on Urinary Stone Treatment During A Pandemic: A Delphi Process from the Endourological Society TOWER Research Initiative. J Endourol 2022; 36:335-344. [PMID: 35019782 DOI: 10.1089/end.2021.0477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has had a significant impact on the care of patients with urolithiasis. Recommendations and prioritization of endourologic surgical procedures vary among regions and a comprehensive overall international directive is needed. We used the Delphi method to obtain international consensus on managing urolithiasis patients during the pandemic. METHODS A three-round Delphi process was used to elicit expert consensus (53 global key opinion leaders within the Endourological Society from 36 countries) on an extensive survey on management of endourologic patients in a pandemic. Questions addressed general management, inpatient and outpatient procedures, clinic visits, follow-up care and best practices for suspension and resumption of routine care. RESULTS Consensus was achieved in 64/84 (76%) questions. Key consensus findings included: consultations should be delivered remotely when possible. Invasive surgical procedures for urolithiasis patients should be reserved for high-risk situations (infection, renal failure, etc.). To prevent aerosolization, spinal anesthesia is preferred over general, whenever feasible. Treatment of asymptomatic renal stones should be deferred. Primary definitive treatment of obstructing or symptomatic stones (both renal and ureteral) is preferred over temporizing drainage. Extracorporeal shock wave lithotripsy should be continued for obstructive ureteral stones. There was consensus on treatment modalities and drainage strategies depending on location and size of the stone. CONCLUSION International endourologist members of the Endourological Society participated in this Delphi initiative to provide expert consensus on management of urolithiasis during a pandemic. These results can be applied currently and during a future pandemic.
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Affiliation(s)
- Kymora Scotland
- The University of British Columbia, 8166, 2775 Laurel Street, Vancouver, British Columbia, Canada, V6T 1Z4;
| | | | - Ben H Chew
- University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Level 6 - 2775 Laurel St, Vancouver, British Columbia, Canada, V5Z 1M9.,University of British Columbia, 8166, Urologic Sciences, 2775 Laurel St, Level 6, Vancouver, British Columbia, Canada, V5Z 1M9;
| | - Naeem Bhojani
- Centre Hospitalier de L'Universite de Montreal, 25443, Urology, 900 St. Denis street, Pavillon R, R08.474, Montreal, Quebec, Canada, H2X 0A9;
| | - R Daron Smith
- University College London Hospitals NHS Foundation Trust, 8964, Institute of Urology, 16-18 Westmoreland Street, London, United Kingdom of Great Britain and Northern Ireland, W1G 8PH;
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Frumer M, Aharony SM, Shoshany O, Kedar D, Baniel J, Golan S. Trends in urological emergencies in the Era of COVID-19. Int Braz J Urol 2021; 47:997-1005. [PMID: 34260177 PMCID: PMC8321443 DOI: 10.1590/s1677-5538.ibju.2020.1092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/24/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate trends in emergency room (ER) urological conditions during COVID-19 pandemic lockdown. MATERIALS AND METHODS Retrospective analyses of renal colic, hematuria, and urinary retention in ER's admissions of a tertiary hospital during the lockdown period (March 19 to May 4, 2020) in Israel. Patient's demographics and clinical characteristics were compared to those in corresponding periods during 2017-2019, with estimated changes in ER arrival and waiting times, utilization of imaging tests, numbers of hospitalizations, and urgent procedure rates. RESULTS The number of ER visits for renal colic, hematuria, and urinary retention decreased by 37%, from an average of 451 (2017-2019) to 261 patients (2020). Clinical severity was similar between groups, with no major differences in patient's age, vital signs, or laboratory results. The proportion of ER visits during night hours increased significantly during lockdown (44.8% vs. 34.2%, p=0.002). There was a decrease in renal colic admission rate from 19.8% to 8.4% (p=0.001) without differences in urgent procedures rates, while the 30-day revisit rate decreased from 15.8% to 10.3% during lockdown (p=0.02). CONCLUSIONS General lockdown was accompanied by a significant decrease in common urological presentations to the ER. This change occurred across the clinical severity spectrum of renal colic, hematuria, and urinary retention. In the short term, it appears that patients who sought treatment did not suffer from complications that could be attributed to late arrival or delay in treatment. The long-term implications of abstinence from seeking emergent care are not known and require further investigation.
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Affiliation(s)
- Michael Frumer
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
| | - Shachar M. Aharony
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ohad Shoshany
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Kedar
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jack Baniel
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Golan
- Rabin Medical CenterDepartment of UrologyPetach TikvaIsraelDepartment of Urology, Rabin Medical Center, Petach Tikva, Israel
- Tel Aviv UniversitySackler Faculty of MedicineTel AvivIsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Teixeira TA, Bernardes FS, Oliveira YC, Hsieh MK, Esteves SC, Duarte AN, Kallas EG, Hallak J. SARS-CoV-2 and Multi-Organ damage - What men's health specialists should know about the COVID-19 pathophysiology. Int Braz J Urol 2021; 47:637-646. [PMID: 33621014 PMCID: PMC7993942 DOI: 10.1590/s1677-5538.ibju.2020.0872] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 02/08/2023] Open
Affiliation(s)
- Thiago A. Teixeira
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade Federal do AmapáFaculdade de MedicinaDivisão de UrologiaAmapáAPBrasilDivisão de Urologia, Faculdade de Medicina, Universidade Federal do Amapá - UNIFAP, Amapá, AP, Brasil
| | - Felipe S. Bernardes
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
| | - Yasmin C. Oliveira
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade Federal do AmapáFaculdade de MedicinaDivisão de UrologiaAmapáAPBrasilDivisão de Urologia, Faculdade de Medicina, Universidade Federal do Amapá - UNIFAP, Amapá, AP, Brasil
| | - Mariana K. Hsieh
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Faculdade de MedicinaCiências da Saúde Albert EinsteinFaculdade IsraelitaSão PauloSPBrasilFaculdade Israelita de Ciências da Saúde Albert Einstein, Faculdade de Medicina, São Paulo, São Paulo, SP, Brasil
| | - Sandro C. Esteves
- Clínica de Andrologia e Reprodução HumanaCampinasSPBrasilANDROFERT, Clínica de Andrologia e Reprodução Humana, Campinas, SP, Brasil
- Universidade Estadual de CampinasDepartamento de CirurgiaCampinasSPBrasilDepartamento de Cirurgia, Disciplina de Urologia, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil
- Aarhus UniversityFaculty of HealthAarhusDenmarkFaculty of Health, Aarhus University, Aarhus, Denmark
| | - Amaro N. Duarte
- Universidade de São PauloDepartamento de PatologiaSão PauloSPBrasilBIAS - Grupo de Estudos de Autópsia de Imagens Brasileiras, Departamento de Patologia, Universidade de São Paulo, SP, Brasil
| | - Esper G. Kallas
- Universidade de São PauloDepartamento de Doenças Infecciosas e ParasitáriasSão PauloSPBrasilDepartamento de Doenças Infecciosas e Parasitárias, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Jorge Hallak
- Laboratório de Andrologia Clínica e de Pesquisa de Alta ComplexidadeCentro de Ciência e Inovação em AndrologiaSão PauloSPBrasilAndroscience - Centro de Ciência e Inovação em Andrologia e Laboratório de Andrologia Clínica e de Pesquisa de Alta Complexidade, São Paulo, SP, Brasil
- Universidade de São PauloDivisão de Clinica UrológicaDepartamento de CirurgiaSão PauloSPBrasilDepartamento de Cirurgia, Divisão de Clinica Urológica Universidade de São Paulo - USP, São Paulo, SP, Brasil
- Universidade de São PauloInstitute for Advanced StudiesMen's Health Study GroupSão PauloSPBrasilMen's Health Study Group, Institute for Advanced Studies, Universidade de São Paulo - USP, SP, Brasil
- Universidade de São PauloDepartamento de PatologiaUnidade de Toxicologia ReprodutivaSão PauloSPBrasilUnidade de Toxicologia Reprodutiva, Departamento de Patologia, Universidade de São Paulo, São Paulo, SP, Brasil
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Favorito LA. Urological tumors treatment in Brazil during the SARS-Cov-2 outbrake. Int Braz J Urol 2020; 47:386-387. [PMID: 33284540 PMCID: PMC7857758 DOI: 10.1590/s1677-5538.ibju.2020.0479.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Luciano A Favorito
- Unidade de Pesquisa Urogenital - Universidade Estadual do Rio de Janeiro - Uerj, Rio de Janeiro, RJ, Brasil.,Serviço de Urologia, Hospital Federal da Lagoa, Rio de Janeiro, RJ, Brasil
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Autrán-Gómez AM, Tobia I, Molina RC, Covarrubias FR, Benzing F, Maruccia S, Reis LDO, Lay RR, la Reza MTD, Torres FS, Porras AH, Rodríguez A. Exploring Urological Experience in the COVID-19 Outbreak: American Confederation of Urology (CAU) Survey. Int Braz J Urol 2020; 46:156-164. [PMID: 32618462 PMCID: PMC7719987 DOI: 10.1590/s1677-5538.ibju.2020.s119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To explore the current situation faced by Latin American urology departments during the COVID-19 Outbreak in terms of knowledge, actions, prioritization of urology practices, and implementation of internal clinical management protocols for inpatients and outpatients. MATERIAL AND METHODS A non-validated, structured, self-administered, electronic survey with 35 closed multiple choice questions was conducted in Spanish, Portuguese, Italian, and English and Deutsch versions from April 1st to April 30th, 2020. The survey was distributed through social networks and the official American Confederation of Urology (CAU) website. It was anonymous, mainly addressed to Latin American urologists and urology residents. It included 35 questions exploring different aspects: 1) Personal Protective Equipment (PPE) and internal management protocols for healthcare providers; 2) Priority surgeries and urological urgencies and 3) Inpatient and outpatient care. RESULTS Of 864 surveys received, 846 had at least 70% valid responses and were included in the statistical analyses. Surveys corresponded to South America in 62% of the cases, Central America and North America in 29.7%. 12.7% were residents. Regarding to PPE and internal management protocols, 88% confirmed the implementation of specific protocols and 45.4% have not received training to perform a safe clinical practice; only 2.3% reported being infected with COVID-19. 60.9% attended urgent surgeries. The following major uro-oncologic surgeries were reported as high priority: Radical Nephrectomy (RN) 58.4%, and Radical Cystectomy (RC) 57.3%. When we associate the capacity of hospitalization (urologic beds available) and percentage of high-priority surgery performed, we observed that centers with fewer urological beds (10-20) compared to centers with more urological beds (31-40) performed more frequently major urologic cancer surgeries: RN 54.5% vs 60.8% (p=0.0003), RC 53.1% vs 64.9% (p=0.005) respectively. CONCLUSIONS At the time of writing (May 13th 2020) our data represents a snapshot of COVID-19 outbreak in Latin American urological practices. Our findings have practical implications and should be contextualized considering many factors related to patients and urological care: The variability of health care scenarios, institutional capacity, heterogeneity and burden of urologic disease, impact of surgical indications and decision making when prioritizing and scheduling surgeries in times of COVID-19 pandemic.
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Affiliation(s)
- Ana María Autrán-Gómez
- University Hospital Fundación Jiménez DíazDepartment of UrologyMadridSpainDepartment of Urology, University Hospital Fundación Jiménez Díaz, Madrid, Spain
| | - Ignacio Tobia
- Hospital Italiano de Buenos AiresDepartment of UrologyBuenos AiresArgentinaDepartment of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Ricardo Castillejos Molina
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránDepartment of UrologyMexico CityMexicoDepartment of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Francisco Rodríguez Covarrubias
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránDepartment of UrologyMexico CityMexicoDepartment of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Frank Benzing
- Brandenburg Medical School University Hospital Brandenburg der HavelDepartment of UrologyGermanyDepartment of Urology, Brandenburg Medical School University Hospital Brandenburg der Havel, Germany
| | - Serena Maruccia
- Institute ZucchiDepartment of UrologyMonzaItalyDepartment of Urology, Institute Zucchi, Monza, Italy
| | - Leonardo de O. Reis
- Universidade Estadual de Campinas - UnicampDepartamento de UrologiaCampinasSPBrasilDepartamento de Urologia, UroScience, Universidade Estadual de Campinas - Unicamp, Campinas, SP, Brasil
| | - Ramón Rodríguez Lay
- Complejo Hospitalario MetropolitanoClinic Urology ServiceMadridPanamaClinic Urology Service, Complejo Hospitalario Metropolitano, Caja de Seguro Social Dr. Arnulfo Arias Madrid, Panama
| | - Marcelo Torrico De la Reza
- San Simón Higher University CochabambaClinic Urology ServiceBoliviaClinic Urology Service, Los Olivos, San Simón Higher University Cochabamba, Bolivia
| | - Felix Santaella Torres
- Hospital de Especialidades - Instituto Mexicano del Seguro Social MexicoCentro Médico NacionalDepartment of UrologyMexico-CityMexicoDepartment of Urology, Centro Médico Nacional, La Raza, Hospital de Especialidades - Instituto Mexicano del Seguro Social Mexico, Mexico-City
| | - Andrés Hernández Porras
- Hospital Angeles TiujanaDepartment of UrologyBaja California NorteMexicoDepartment of Urology, Hospital Angeles Tiujana, Baja California Norte, Mexico
| | - Alejandro Rodríguez
- Rochester General HospitalDepartment of UrologyRochester New YorkUSDepartment of Urology, Rochester General Hospital, Rochester New York, US
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Esperto F, Prata F, Civitella A, Pang KH, Marchioni M, Tuzzolo P, Scarpa RM, Papalia R. Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic. Int Braz J Urol 2020; 46:170-180. [PMID: 32649082 PMCID: PMC7719985 DOI: 10.1590/s1677-5538.ibju.2020.s122] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 05/10/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. MATERIALS AND METHODS In May the 6th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents' activity. A narrative summary of guidelines and current literature for each point of interest was performed. CONCLUSION In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.
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Affiliation(s)
- Francesco Esperto
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesco Prata
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Angelo Civitella
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Karl H. Pang
- University of SheffieldDepartment of OncologySheffieldUnited Kingdom, UKDepartment of Oncology University of Sheffield, Sheffield, United Kingdom, UK
- University of SheffieldDepartment of MetabolismSheffieldUnited Kingdom, UKDepartment of Metabolism, University of Sheffield, Sheffield, United Kingdom, UK
| | - Michele Marchioni
- University of ChietiDepartment of Medical Oral and Biotechnological Sciences “G D'Annunzio”ItalyDepartment of Medical Oral and Biotechnological Sciences “G D'Annunzio” University of Chieti. Urology Unit SS Annunziata Hospital Chieti, Italy
| | - Piergiorgio Tuzzolo
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Roberto M. Scarpa
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Rocco Papalia
- Campus Bio-Medico University of RomeDepartment of UrologyRomeItalyDepartment of Urology, Campus Bio-Medico University of Rome, Rome, Italy
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