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Urol Oncol ; 39(5): 298.e7-298.e11, 2021 05.
Article in English | MEDLINE | ID: covidwho-779731


OBJECTIVES: To assess potential nosocomial coronavirus disease-2019 (COVID-19) transmission in patients who underwent robot-assisted laparoscopic procedures during the pandemic. MATERIAL AND METHODS: Prospective study in patients undergoing robot-assisted laparoscopy in urology or gynaecology within 2 academic hospitals. Patients underwent local preoperative COVID-19 screening using a symptoms questionnaire. Patients with suspicious screening underwent coronavirus real time-polymerase chain reaction (RT-PCR) and were excluded from robotic surgery if positive. Patients with symptoms postsurgery were systematically tested for coronavirus by RT-PCR. One-month postsurgery, all patients had a telephone consultation to evaluate COVID-19 symptoms. RESULTS: Sixty-eight patients underwent robotic surgery during the study period (median age: 63-years [IQR: 53-70], 1.8 male: female ratio). Oncology was the main indication for robotic surgery (n = 62, 91.2%) and 26 patients (38.2%) received a chest CT-scan prior to surgery. Eleven patients (16.2%) were symptomatic after surgery of whom only 1 tested positive for coronavirus by RT-PCR (1.5%) and was transferred to COVID-19 unit with no life-threatening condition. No attending surgeon was diagnosed with COVID-19 during the study. CONCLUSIONS: Robot-assisted laparoscopic surgery seemed safe in the era of COVID-19 as long as all recommended precautions are followed. The rate of nosocomial COVID-19 transmission was extremely low despite the fact that we only used RT-PCR testing in symptomatic patients during the preoperative work-up. Larger cohort is needed to validate these results.

COVID-19/transmission , Cross Infection/diagnosis , Robotic Surgical Procedures/methods , SARS-CoV-2/isolation & purification , Surveys and Questionnaires/statistics & numerical data , Academic Medical Centers , Aged , COVID-19/epidemiology , COVID-19/virology , Female , Gynecologic Surgical Procedures/methods , Gynecologic Surgical Procedures/statistics & numerical data , Humans , Laparoscopy/methods , Male , Middle Aged , Pandemics/prevention & control , Postoperative Period , Prospective Studies , Robotic Surgical Procedures/statistics & numerical data , SARS-CoV-2/physiology , Urologic Surgical Procedures/methods , Urologic Surgical Procedures/statistics & numerical data
World J Urol ; 39(6): 1991-1996, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-754594


PURPOSE: Lockdown during the COVID-19 pandemic compelled urologists to change access to healthcare, especially for oncology patients. Teleconsultation is a safe way to receive medical advice without a risk of infection, and was implemented urgently in our academic centres. Our purpose was to evaluate patient and physician satisfaction with teleconsultation set up during the COVID-19 pandemic. METHODS: From March 16th 2020, all face-to-face consultations were cancelled in France, except for emergencies. Teleconsultation was started immediately by five senior urologists in two academic hospitals. All patients received an email survey including the validated Teleconsultation Satisfaction Questionnaire (TSQ) and demographic questions. Data were collected prospectively. Physicians also responded to the TSQ. Patient satisfaction was measured objectively with the validated 14-item TSQ. Each item was scored on a 5-point Likert scale. Factors associated with positive satisfaction with teleconsultation were assessed by multivariable logistic regression. RESULTS: Overall, 105 patients replied to the survey (91.3%). Median age was 66 years (IQR: 55‒71) and 95 were men (90.5%). Median overall TSQ score was 67 (IQR: 60‒69); teleconsultation was judged to be a good experience by 88 patients (83.8%) and four physicians (80%). Patients who met their surgeon for the first time were more likely to have a good experience (OR = 1.2 [95% CI 1.1‒1.5], p = 0.03). CONCLUSION: Introduced rapidly during the COVID-19 lockdown, urology teleconsultation attained a high level of satisfaction among both patients and physicians. A major change in telemedicine use is foreseen in the post COVID-19 era.

Attitude of Health Personnel , COVID-19 , Patient Preference/statistics & numerical data , Remote Consultation , Urologic Diseases , Urology Department, Hospital , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/organization & administration , Female , France/epidemiology , Humans , Male , Organizational Innovation , Remote Consultation/methods , Remote Consultation/standards , Remote Consultation/statistics & numerical data , Risk Adjustment/methods , SARS-CoV-2 , Surveys and Questionnaires , Urologic Diseases/diagnosis , Urologic Diseases/epidemiology , Urologic Diseases/therapy , Urology Department, Hospital/organization & administration , Urology Department, Hospital/trends
BJU Int ; 126(4): 436-440, 2020 10.
Article in English | MEDLINE | ID: covidwho-703610
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