ABSTRACT
BACKGROUND: Apart from viral sexually transmitted diseases, viral infections in urology are not common and likely to be underreported. Initially, COVID-19 was thought to be only affecting our practice indirectly through reducing elective work that almost came to a stop. However, recent upcoming reports show that urologists can get involved far beyond that. MAIN BODY: Genitourinary tract can be directly affected based on the SARS-CoV-2 virus organotropism. The aim of this article is to present a comprehensive review of the data available and to highlight any possible similarity with the few known viral infections involving genitourinary organs with regard to its pathophysiologic impact. CONCLUSION: Urologists need to extrapolate their experience with viral infections in the urinary tract so as to be able to manage such possible COVID infections and its short- and long-term consequences.
ABSTRACT
During the coronavirus disease 2019 pandemic, there has been a reduction in the provision of all elective services. This poses enormous pressure on urologists as regards to patients with bladder cancer who need intravesical Bacille Calmette Guerin (BCG) treatment. The evolving situation of the pandemic mandates a pragmatic approach in clinical decisions; to date, there are no uniform consensus guidelines about how to manage these patients and the factors affecting our decision for service provision. These concerns need to be addressed not only for the current crisis but also for the upcoming next phase of the pandemic.
ABSTRACT
The current coronavirus disease 2019 (COVID-19) pandemic is massively affecting our daily practice. Elective surgical service has been significantly altered, i.e. reduced overall service provision, special operating theatres' precautions, as well as considerations for testing patients before surgery. The process of counselling patients and obtaining their consent is a must before any surgical intervention. Several factors can affect this process particularly amid the current pandemic crisis. Only with a full understanding of all the relevant facts, including risks and available alternatives, can patients give an 'informed consent'. Therefore, we urologists need to be aware of the impact of the current COVID-19 situation on how to consent our patients. ABBREVIATIONS: COVID-19: coronavirus disease 2019; PPE: personal protective equipment.
ABSTRACT
To search for evidence base for using BCG in the fight against COVID-19 and the possible impact of these clinical trials on urology practice. A literature review about the basis of the ongoing clinical trials using BCG against COVID-19, as well as the use of BCG in urology and if there are any implications of these trials on our practice. Based on data from some epidemiological studies, there are some current clinical trials on the use BCG as a possible prophylactic vaccine against SARS CoV-2 which can affect urology practice. Urologists are already struggling with the global shortage of BCG which can be even more aggravated by such trials. In addition, if the ongoing trials proved the efficacy of BCG as a prophylaxis against COVID-19, this may open the door to more urological research opportunities to question the possibility that intra-vesical BCG, given its systemic immunologic effect, may have been protective to this subgroup of urological patients. The ongoing clinical trials using BCG against COVID-19 can affect our urology practice. We need to stay vigilant to such impacts: BCG shortage and possible new chances for urology research work.
Subject(s)
Coronavirus Infections/epidemiology , Learning , Pneumonia, Viral/epidemiology , Practice Guidelines as Topic , Urology/methods , Adjuvants, Immunologic/therapeutic use , Administration, Intravesical , BCG Vaccine/therapeutic use , Betacoronavirus , Biomedical Research/methods , COVID-19 , Carcinoma, Transitional Cell/therapy , Humans , Kidney Neoplasms/therapy , Laparoscopy/methods , Pandemics , Robotic Surgical Procedures/methods , SARS-CoV-2 , Telemedicine/methods , Ureteral Neoplasms/therapy , Urinary Bladder Neoplasms/drug therapy , Urolithiasis/therapy , Urologic Surgical Procedures/methods , Urologists , Urology/standardsABSTRACT
Introduction: The COVID-19 pandemic represents an uncertain challenge that could generate large numbers of patients in a short period of time. Methods: How best to manage this situation is evolving. There will not be an ideal solution so we must all work together to solve the challenge. Results: Applying principles of mass casualty medicine in triaging urology patients in need of elective and emergent surgeries is of paramount importance. Conclusions: Accordingly, there is a crucial need to find a guide to pragmatic management of urological patients during this pandemic.