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Neurourol Urodyn ; 40(5): 1200-1206, 2021 06.
Article in English | MEDLINE | ID: covidwho-1212770


OBJECTIVE: Early reports have suggested that coronavirus disease 2019 (COVID-19) can present with significant urinary frequency and nocturia, and that these symptoms correlate with markers of inflammation in the urine. We evaluated surrogate markers of chronic urinary symptoms to determine if they were more frequent after COVID-19 infection. METHODS: Routinely collected data from the province of Ontario was used to conduct a matched, retrospective cohort study. We identified patients 66 years of age or older who had a positive COVID-19 test between February and May 2020 and survived at least 2 months after their diagnosis. We matched them to two similar patients who did not have a positive COVID-19 test during the same time period. We measured the frequency of urology consultation, cystoscopy, and new prescriptions for overactive bladder medications during a subsequent 3-month period. Proportional hazard models were adjusted for any baseline differences between the groups. RESULTS: We matched 5617 patients with COVID-19 to 11,225 people who did not have COVID-19. The groups were similar, aside from a higher proportion of patients having hypertension and diabetes in the CoVID-19 cohort. There was no significantly increased hazard of new receipt of overactive bladder medication (hazards ratio [HR]: 1.04, p = 0.88), urology consultation (HR: 1.40, p = 0.10), or cystoscopy (HR: 1.14, p = 0.50) among patients who had COVID-19, compared to the matched cohort. CONCLUSION: Surrogate markers of potential bladder dysfunction were not significantly increased in the 2-5 months after COVID-19 infection.

COVID-19/physiopathology , Urinary Bladder, Overactive/virology , Aged , COVID-19/epidemiology , COVID-19/urine , Case-Control Studies , Cohort Studies , Female , Humans , Inflammation Mediators/urine , Male , Ontario/epidemiology , Retrospective Studies , SARS-CoV-2/isolation & purification , Urinary Bladder, Overactive/epidemiology , Urinary Bladder, Overactive/physiopathology , Urinary Bladder, Overactive/urine
Eur Urol Focus ; 6(5): 1049-1057, 2020 Sep 15.
Article in English | MEDLINE | ID: covidwho-597672


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.

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