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1.
Neurourol Urodyn ; 41(2): 643-649, 2022 02.
Article in English | MEDLINE | ID: covidwho-1616037

ABSTRACT

OBJECTIVES: Coronavirus disease 2019 (COVID-19) pandemic has caused a massive cutdown in outpatient urological investigations, procedures, and interventions. Female and functional urology (FFU) has been probably the most affected subspecialty in urology. Several scientific societies have published guidelines to manage this new situation, providing general recommendations. The aim of this study was to devise a robust questionnaire covering every different aspect of FFU to obtain recommendations on COVID-19 adaptations. METHODS: Delphi methodology was adapted to devise the survey questionnaires for male/female lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP), chronic pelvic pain (CPP), and neuro-urological disease. Content validity, face validity, and internal consistence were assessed to establish the final questionnaire. This study was ethically approved by the Local Research Ethics Committee. RESULTS: A total 97, 59, 79, 85, and 84 items for female and male LUTS, POPs, CPP, and neuro-urology respectively were approved by the participants. Content validity over 0.70 was obtained which seemed reasonable content validity scores. Internal consistency obtains values of Cronbach's alpha was between 0.70 and 0.90 which was acceptable. CONCLUSIONS: The collective wisdom obtained through a global survey using validated questionnaires covering every different aspect of FFU patient management is necessary. We have developed a robust and validated tool consisting of five questionnaires covering the most prevalent pathologies in FFU.


Subject(s)
COVID-19 , Urology , Female , Humans , Male , Reproducibility of Results , SARS-CoV-2 , Surveys and Questionnaires , Urologic Surgical Procedures/methods
2.
Archivos espanoles de urologia ; 73(5):420-428, 2020.
Article | WHO COVID | ID: covidwho-601893

ABSTRACT

OBJECTIVES: Due to the COVID-19 Pandemic, all surgical activity that was not life threatening was cancelled , as well as most face-to-face consultations. Currently the beginning of the de-escalation phases that will led us to a new normal, forces us to establish some degree of priority in the interventions as well as in the medical consultations. Our objective is to establish some recommendation on Functional Urology office visits and surgical interventions that serve as a tool to facilitate decision-making.MATERIAL AND METHODS: Experts in Functional Urology from different autonomous communities of Spain were contacted to design a strategy to reorganize the activity of both, diagnosis and treatment. A modified nominal group technique has been used due to the extraordinary restrictions of assembly and mobility during the COVID pandemic. The first signer (EMC) made the first draft with the measures adopted and the strategy to be followed during the evolution of the COVID-19 pandemic. The proposal was sent to the rest of the authors, in order to unify criteria and experiences to reach a quick consensus on the relative priority of the different activities, problems and solutions. A final version was approved by all authors May 27, 2020.RESULTS:Tables of recommendation have been prepared for outpatient consultation, surgical and technical interventions, according to de-escalation phases proposed by the Spanish Associations of Surgeons.CONCLUSIONS: The change that COVID-19 Pandemich as involved in our clinical practice force us to seek alternative methods to treat our patients, some of which may already be established. Mean while, a consensusin decision making is necessary. Documents such as the current one, are intended to guide the management of patients with urological functional pathology in exceptional situations. Logically, it should be adapted to material and human availability, and to the idiosyncrasy of each Urology service. OBJETIVOS: Debido a la Pandemia COVID-19 se suspendio toda actividad quirurgica que no fuera una urgencia vital, asi como la mayoria de consultas presenciales. Actualmente el inicio de las fases dedesescalada que nos llevaran a una nueva normalidad nos obliga a establecer unos grados de prioridad en las intervenciones asi como en las consultas medicas. Nuestro objetivo es establecer una serie de recomendaciones sobre las consultas de Urologia Funcional y las intervenciones quirurgicas que sirva como herramientade ayuda en la toma de decisiones.MATERIAL Y METODOS: Expertos en Urologia Funcionalde distintas comunidades autonomas de Espana fueron contactados para disenar una estrategia parareorganizar la actividad tanto de diagnostico como de tratamiento. Se ha utilizado una tecnica de grupo nominal modificada debido a las restricciones extraordinarias de reunion y movilidad durante la pandemia COVID. El primer firmante (EMC) realizo el primer borrado rcon las medidas adoptadas y la estrategia a seguir durante la evolucion de la pandemia COVID19. Se remitio la propuesta al resto de autores, con el fin de unificar criterios y experiencias para llegar a un rapido consenso sobre la importancia relativa de las distintas actividades, problemas y soluciones. Se realizo una version definitiva, aprobada por todos los autores, el dia 27 de mayo de 2020.RESULTADOS: Se han elaborado tablas de recomendaciones tanto para consultas externas, como para intervenciones quirurgicas y tecnicas, de acuerdo con las fases de desescalada propuestas por la Asociacion Espanola de Cirujanos (AEC). CONCLUSIONES: El cambio que ha supuesto la Pandemia COVID-19 en nuestra practica clinica nos obliga a buscar metodos alternativos para seguir y tratar a nuestros pacientes, algunos de los cuales pueden ya quedar instaurados. Mientras, es necesario un consenso en la toma de decisiones. Documentos como el actual, pretenden orientar en el manejo de los pacientes con patologia funcional urologica en situaciones excepcionales. Logicamente, debera adaptarse alas disponibilidades materiales y humanas, y a la idiosincrasia de cada ser icio de Urologia.

3.
Archivos espanoles de urologia ; 73(5):420-428, 2020.
Article | WHO COVID | ID: covidwho-601892

ABSTRACT

OBJECTIVES: Due to the COVID-19 Pandemic, all surgical activity that was not life threatening was cancelled , as well as most face-to-face consultations. Currently the beginning of the de-escalation phases that will led us to a new normal, forces us to establish some degree of priority in the interventions as well as in the medical consultations. Our objective is to establish some recommendation on Functional Urology office visits and surgical interventions that serve as a tool to facilitate decision-making. MATERIAL AND METHODS: Experts in Functional Urology from different autonomous communities of Spain were contacted to design a strategy to reorganize the activity of both, diagnosis and treatment. A modified nominal group technique has been used due to the extraordinary restrictions of assembly and mobility during the COVID pandemic. The first signer (EMC) made the first draft with the measures adopted and the strategy to be followed during the evolution of the COVID-19 pandemic. The proposal was sent to the rest of the authors, in order to unify criteria and experiences to reach a quick consensus on the relative priority of the different activities, problems and solutions. A final version was approved by all authors May 27, 2020. RESULTS: Tables of recommendation have been prepared for outpatient consultation, surgical and technical interventions, according to de-escalation phases proposed by the Spanish Associations of Surgeons. CONCLUSIONS: The change that COVID-19 Pandemich as involved in our clinical practice force us to seek alternative methods to treat our patients, some of which may already be established. Mean while, a consensusin decision making is necessary. Documents such as the current one, are intended to guide the management of patients with urological functional pathology in exceptional situations. Logically, it should be adapted to material and human availability, and to the idiosyncrasy of each Urology service.

4.
Eur Urol Focus ; 6(5): 1049-1057, 2020 Sep 15.
Article in English | MEDLINE | ID: covidwho-597672

ABSTRACT

CONTEXT: Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients with benign and disabling conditions who are suffering delays in medical attention that impact their quality of life. OBJECTIVE: To propose, based on expert advice and current evidence where available, a strategy to reorganize female and functional urological (FFU) activity (diagnosis and treatment). EVIDENCE ACQUISITION: The present document is based on a narrative review of the limited data available in the urological literature on SARS-Cov-2 and the experience of FFU experts from several countries around the world. EVIDENCE SYNTHESIS: In all the treatment schemes proposed in the literature on the COVID-19 pandemic, FFU surgery is not adequately covered and usually grouped into the category that is not urgent or can be delayed, but in a sustained pandemic scenario there are cases that cannot be delayed that should be considered for surgery as a priority. The aim of this document is to provide a detailed management plan for noninvasive and invasive FFU consultations, investigations, and operations. A classification of FFU surgical activity by indication and urgency is proposed, as well as recommendations adopted from the literature for good surgical practice and by surgical approach in FFU in the COVID-19 era. CONCLUSIONS: Functional, benign, and pelvic floor conditions have often been considered suitable for delay in challenging times. The long-term implications of this reduction in functional urology clinical activity are currently unknown. This document will help functional urology departments to reorganize their activity to best serve their patients. PATIENT SUMMARY: Many patients will suffer delays in urology treatment because of COVID-19, with consequent impairment of their physical and psychological health and deterioration of their quality of life. Efforts should be made to minimize the burden for this patient group, without endangering patients and health care workers.


Subject(s)
Coronavirus Infections/prevention & control , Pandemics/prevention & control , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Telemedicine , Urologic Diseases/diagnosis , Urologic Diseases/therapy , Urology/methods , Ambulatory Care , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Cystitis, Interstitial/diagnosis , Cystitis, Interstitial/therapy , Disease Management , Female , Humans , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/therapy , Male , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2 , Urinary Incontinence/diagnosis , Urinary Incontinence/therapy , Urinary Retention/diagnosis , Urinary Retention/therapy , Urinary Tract Infections/diagnosis , Urinary Tract Infections/therapy , Urologic Surgical Procedures , Vesicovaginal Fistula/diagnosis , Vesicovaginal Fistula/therapy
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