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2.
Int. braz. j. urol ; 47(3): 479-481, May-June 2021.
Article in English | LILACS | ID: biblio-1154512

Subject(s)
Humans , Urology , Infertility , Brazil
3.
Gac. méd. boliv ; 44(1): 44-49, jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1286598

ABSTRACT

Objetivo: describir la incidencia de tuberculosis urogenital (TBUG) en los dos centros de referencia diagnóstica del sistema de salud público del departamento de Cochabamba. Métodos: estudio transversal retrospectivo desde enero de 2013 a marzo de 2020; población de estudio: pacientes con sospecha de TBUG con solicitud de cultivo para BK. Recolección de datos: base de datos de los laboratorios y revisión de los expedientes clínicos. Resultados: se identificó a 2266 pacientes con sospecha clínica de TBUG a los que se les realizó cultivos de orina para TB; de los cuales 133 (5,87%) pacientes resultaron con cultivo positivo: 87 de sexo masculino (65,4%) y 46 de sexo femenino (34,6%); De estos, 115 pacientes no cuentan con un seguimiento completo clínico ni microbiológico, de los cuales el 83,3% tenía TB renal, 11,1% genital y 5,6% vesical; el 77,8 % presentaron síntomas del tracto urinario inferior, 33,3 % tenía algún tipo de comorbilidad y 1 requirió cirugía urológica. El tratamiento antituberculoso fue el estándar en el 100%, 1 presentó reacción adversa, pero ninguna resistencia ni defunciones asociadas al tratamiento. Discusión: la incidencia del 5,87% no es despreciable, debido a que se requiere un alto índice de sospecha y contar con el cultivo para el diagnóstico, seguimiento y finalización de la terapia y de este modo disminuir el daño irreversible que afectan la funcionalidad.


Objective: to determine the incidence of urogenital tuberculosis (UGTB) in the 2 diagnostic reference centers of Cochabamba. Methods: retrospective cross-sectional study from January 2013 to March 2020; Study population: patients with suspected UGTB with culture request for BK. Data collection: Laboratory database and review of clinical records. Results: 2266 patients with clinical suspicion of UGTB who had urine cultures for TB were identified; of which 133 (5.87%) patients were culture positive: 87 male (65.4%) and 46 female (34.6%); Of these, 115 patients do not have complete follow-up and only 18 patients were evaluated, of which 83.3% had renal TB, 11.1% genital and 5.6% bladder; 77.8% had lower urinary tract symptoms, 33.3% had some type of comorbidity and 1 required urological surgery. Antituberculosis treatment was standard in 100%, 1 presented adverse reaction, but no resistance or deaths associated with the treatment. Discussion: the incidence of 5.87% is not negligible, due to the fact that a high index of suspicion is required and to have the culture for diagnosis, follow-up and termination of therapy and thus reduce irreversible damage affecting functionality.


Subject(s)
Urology
5.
Int. braz. j. urol ; 47(2): 251-262, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154446

ABSTRACT

ABSTRACT COVID-19 pandemic is a rapidly spreading virus that is changing the World and the way doctors are practicing medicine. The huge number of patients searching for medical care and needing intensive care beds led the health care system to a burnout status especially in places where the care system was already overloaded. In this setting, and also due to the absence of a specific treatment for the disease, health authorities had to opt for recommending or imposing social distancing to relieve the health system and reduce deaths. All other medical specialties nondirectly related to the treatment of COVID-19 had to interrupt or strongly reduce their activities in order to give room to seriously ill patients, since no one knows so far the real extent of the virus damage on human body and the consequences of doing non deferrable procedures in this pandemic era. Despite not been a urological disease, the urologist needs to be updated on how to deal with these patients and how to take care of himself and of the medical team he works with. The aim of this article is to review briefly some practical aspects of COVID-19 and its implications in the urological practice in our country.


Subject(s)
Humans , Urologic Diseases/therapy , Urology/trends , Pandemics , COVID-19
8.
Int. braz. j. urol ; 47(2): 378-385, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1154455

ABSTRACT

ABSTRACT Introduction: The rapid spread of coronavirus disease 2019 (COVID-19) has dramatic effects on individuals and health care systems. In our institute, a tertiary oncologic public hospital with high surgical volume, we prioritize maintaining cancer treatment as well as possible. The aim of this study is to evaluate if uro-oncological surgeries at pandemic are safe. Materials and Methods: We evaluated patients who underwent uro-oncological procedures. Epidemiological data, information on COVID-19 infection related to surgery and clinical characteristics of non-survival operative patients with COVID-19 infections were analyzed. Results: From 213 patients analyzed, Covid-19 symptoms were noticed in 8 patients at preoperative process or at hospital admission postponing operation; 161 patients were submitted to elective surgery and 44 to emergency surgery. From patients submitted to elective surgeries, we had 1 patient with laboratory confirmation of COVID-19 (0,6%), with mild symptoms and quick discharge. From the urgencies group, we had 6(13%) patients tested positive; 5 were taken to ICU with 4 deaths. Conclusion: Elective uro-oncological procedures at the COVID-19 epidemic period in a COVID-19-free Institute are safe, and patients who need urgent procedures, with a long period of hospitalization, need special care to avoid COVID-19 infection and its outcomes.


Subject(s)
Humans , Urology/statistics & numerical data , Pandemics , Surgical Oncology/statistics & numerical data , COVID-19 , Brazil/epidemiology
9.
Int. braz. j. urol ; 47(1): 1-3, Jan.-Feb. 2021.
Article in English | LILACS | ID: biblio-1134324
10.
Int. braz. j. urol ; 47(1): 4-5, Jan.-Feb. 2021. graf
Article in English | LILACS | ID: biblio-1134323
11.
Rev. ANACEM (Impresa) ; 15(1): 72-78, 2021.
Article in Spanish | LILACS | ID: biblio-1281220

ABSTRACT

La incontinencia urinaria de urgencia corresponde a la pérdida involuntaria de orina, cuya causa es presumida multifactorial: hiperactividad del detrusor, hipersensibilidad vesical y distensibilidad reducida del detrusor. Esta patología es bastante frecuente tanto en Chile como en el mundo, con una prevalencia local entre 10% y 15%, a su vez genera un gran impacto en el bienestar físico, mental y socioeconómico del paciente. El diagnóstico es clínico, con apoyo en el uroanálisis y su tratamiento de primera línea puede ser realizado en APS. En cuanto al tratamiento existen tanto terapias no farmacológicas como farmacológicas; correspondiendo las técnicas de reentrenamiento vesical, los cambios de estilo de vida y los fármacos anticolinérgicos a tratamientos efectivos de primera línea. Existen, además, otros fármacos que pueden ser utilizados para el tratamiento de la IUU, cuya evidencia será igualmente revisada en este artículo.


Urge incontinence is defined as an involuntary leakage of urine, presumably with a multifactorial cause: detrusor overactivity, bladder hypersensibility and a reduced bladder compliance. It's a common disease worldwide, with local studies reporting a prevalence around 10-15%, causing a great impact in the physical, mental and socioeconomic well-being of the affected patients. Diagnosis is mainly based on the clinical history, supporting it with laboratory tests to rule out other conditions, and uncomplicated cases can be treated and followed in a primary care setting. There are pharmacologic and non-pharmacologic therapies, being healthy lifestyles changes, bladder retraining programs and anticholinergic drugs the first line of treatment. Additional pharmacologic treatments will be revised in this article.


Subject(s)
Humans , Female , Primary Health Care , Quality of Life , Urinary Incontinence, Urge/diagnosis , Urinary Incontinence, Urge/drug therapy , Urinary Incontinence/epidemiology , Urology , Urinary Incontinence, Urge/therapy , Urinary Incontinence, Urge/epidemiology
12.
Int. braz. j. urol ; 46(6): 1042-1071, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134250

ABSTRACT

ABSTRACT Objectives To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020. Materials and Methods A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states. Results Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012). Conclusions COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.


Subject(s)
Humans , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Urologic Surgical Procedures/statistics & numerical data , Urologic Diseases/therapy , Urology/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Workload , Coronavirus Infections , Pandemics , Urologists/psychology , Betacoronavirus , Life Style , Quality of Life , Urologic Diseases/complications , Urologic Diseases/epidemiology , Practice Patterns, Physicians'/trends , Brazil , Surveys and Questionnaires , Telemedicine , Urologists/statistics & numerical data , SARS-CoV-2 , COVID-19
17.
Int. braz. j. urol ; 46(supl.1): 133-144, July 2020. tab
Article in English | LILACS | ID: biblio-1134296

ABSTRACT

ABSTRACT Medical and surgical priorities have changed dramatically at the time of this pandemic. Scientific societies around the World have provided rapid guidance, underpinned by the best knowledge available, on the adaptation of their guidelines recommendations to the current situation. There are very limited scientific evidence especially in our subspecialty of pediatric urology. We carry out a review of the little scientific evidence based mainly on the few publications available to date and on the recommendations of the main scientific societies regarding which patients should undergo surgery, when surgery should be performed and how patient visits should be organize.


Subject(s)
Humans , Child , Pediatrics/trends , Pneumonia, Viral/complications , Urology/trends , Coronavirus Infections/complications , Coronavirus , Delivery of Health Care/trends , Betacoronavirus , Pneumonia, Viral/epidemiology , Coronavirus Infections/epidemiology , Pandemics , Personal Protective Equipment , SARS-CoV-2 , COVID-19
18.
Int. braz. j. urol ; 46(supl.1): 215-221, July 2020. tab, graf
Article in English | LILACS | ID: biblio-1134295

ABSTRACT

ABSTRACT Known laparoscopic and robotic assisted approaches and techniques for the surgical management of urological malignant and benign diseases are commonly used around the World. During the global pandemic COVID-19, urology surgeons had to reorganize their daily surgical practice. A concern with the use of minimally invasive techniques arose due to a proposed risk of viral transmission of the coronavirus disease with the creation of pneumoperitoneum. Due to this, we reviewed the literature to evaluate the use of laparoscopy and robotics during the pandemic COVID-19. A literature review of viral transmission in surgery and of the available literature regarding the transmission of the COVID-19 virus was performed up to April 30, 2020. We additionally reviewed surgical society guidelines and recommendations regarding surgery during this pandemic. Few studies have been performed on viral transmission during surgery. No study has been made regarding this area during minimally invasive urology cases. To date there is no study that demonstrates or can suggest the ability for a virus to be transmitted during surgical treatment whether open, laparoscopic or robotic. There is no society consensus on restricting laparoscopic or robotic surgery. However, there is expert consensus on modification of standard practices to minimize any risk of transmission. During the pandemic COVID-19 we recommend the use of specific personal protective equipment for the surgeon, anesthesiologist and nursing staff in the operating room. Modifications of standard practices during minimally invasive surgery such as using lowest intra-abdominal pressures possible, controlled smoke evacuation systems, and minimizing energy device usage are recommended.


Subject(s)
Pneumonia, Viral/complications , Urologic Surgical Procedures/methods , Urology/standards , Urology/trends , Laparoscopy/methods , Coronavirus Infections/complications , Disease Transmission, Infectious/prevention & control , Pandemics , Robotic Surgical Procedures/methods , Urologists , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Pneumonia, Viral/epidemiology , Urologic Surgical Procedures/trends , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Workflow , Robotic Surgical Procedures/trends , Betacoronavirus , SARS-CoV-2 , COVID-19
19.
Int. braz. j. urol ; 46(supl.1): 207-214, July 2020. tab, graf
Article in English | LILACS | ID: biblio-1134289

ABSTRACT

ABSTRACT Over the course of several weeks following the first diagnosed case of COVID-19 In the U.S., the virus rapidly spread across our communities. It became evident that the pandemic was going to place a severe strain on all components of the U.S. healthcare system, and we needed to adapt our daily practices, training and education. In the present paper we discuss four pillars to face a pandemic: surgical and outpatients service, tele-medicine and tele-education. In the face of unprecedented risks in providing adequate health care to our patients during this current, evolving public health crisis of COVID-19, alternative patient management tools such as telemedicine services, allow clinicians to maintain necessary patient rapport with their healthcare provider when required. As a subspecialty, urology should take full advantage of telehealth and teleeducation at this juncture. As tele-urology and tele-education can obviate the potential drawbacks of "social distancing" as it pertains to healthcare, the platform can also reduce the risk of COVID-19 spread, without compromising quality urological care and educational efforts. Telehealth can bring urologists and their patients together, perhaps closer than ever.


Subject(s)
Humans , Pneumonia, Viral/complications , Urology/methods , Coronavirus Infections/complications , Coronavirus , Pandemics , Urologists , Pneumonia, Viral/epidemiology , United States , Coronavirus Infections/epidemiology , Betacoronavirus , SARS-CoV-2 , COVID-19
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