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1.
Transl Androl Urol ; 10(7): 2857-2870, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1518879

ABSTRACT

BACKGROUND: Penile curvature (PC) can be surgically corrected by plication techniques or Nesbit corporoplasty. These shortening techniques can be complicated by post-operative: penile shortening, recurrent PC, palpable suture knots and erectile dysfunction. Furthermore, Nesbit procedures require the use of a penile tourniquet to avoid intraoperative bleeding. This observational study aims to assess the results of Nesbit modified corporoplasty, avoiding intraoperative use of tourniquet without risk of bleeding. The objective is to reduce penile ischemic anatomical and functional damages such as long-term erectile dysfunction. METHODS: Between January 2010 and March 2019, a total of 64 patients with congenital penile curvature (CPC) and Peyronie's disease (PD) underwent surgical correction with a Nesbit modified technique first time described by Rolle et al., with minimal technical differences. The operation notes were retrospectively reviewed. In particular, we evaluated pre- and post-operative erectile functions using IIEF-5 score, penile Doppler ultrasonography and overall patient satisfaction. RESULTS: During operations, no intraoperative bleeding was noted, and no short-term complications such as hematomas or neurovascular bundle lesions were reported. At 6 months, no palpable subcutaneous indurations and no sensory change were detected. Post-operative penile shortening was reported in 38 (59.4%) patients (mean 0.83±0.79 cm), but it did not influence the high overall satisfaction rate of 91.4%. Only 2 patients reported a slightly partial recurrence of curvature (<15%) with no need for a redo surgery. Mean IIEF-5 score increased from 17.1±5.2 to 20.8±3.9 at 6 months and 21.8±3.4 at 12 months (P<0.001 in both cases). Mean PSV also significantly increased at the end of follow-up (28.5±6.1 at baseline vs. 31.0±7.1 at 12 months, P=0.03). CONCLUSIONS: Considering the optimal results in terms of erectile functions increasing and absence of PC recurrence (>15°), we think that Nesbit modified corporoplasty without tourniquet application during reconstruction is a safe and effective surgical procedure for all kind of shortening corporoplasty to reduce the time of penile ischemia, preventing even serious consequences for the normal physiology of erection.

3.
Eur Urol Open Sci ; 31: 37-40, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1313107

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led to significant changes in urology practice and residency programs. One year ago, the first nationwide survey on this topic showed a dramatic impact of the acute phase of the pandemic on residents' training activities. Aiming to assess for the first time how the COVID-19 scenario reshaped the pattern of urology training over a whole pandemic year, a cross-sectional, 38-item, web-based survey was developed. Residents scored the percentage decrease of their involvement in various clinical and surgical activities during the period of March 2020-March 2021 (as compared with the pre-COVID period). Overall, 312/585 (53.3%) residents from 27 schools of urology were included. The proportions of those experiencing a significant decrease of training exposure were 13.6%, 28.8%, 26.7%, 46.9%, 37.6%, and 33.3% (as compared with 40.2%, 85.8%. 82.3%, 69.7%, 59.7%, and 50.2% in the previous survey) for on-call activities, outpatient visits, diagnostic procedures, endoscopic surgery, open surgery, and minimally invasive surgery, respectively. The most impactful reductions in training activities were reached by final-year residents. Our findings highlight that, even if less burdensome than expected, urology residency training (especially in endoscopic surgery) was highly affected throughout the whole past year. This critical gap of skills may jeopardize residents' training even beyond the COVID-19 pandemic. PATIENT SUMMARY: In this study, we assessed whether the training activities of Italian urology residents were impacted negatively by a whole year of COVID-19 pandemic (March 2020-March 2021). We also compared our results with those reported in a previous survey evaluating how the coronavirus disease 2019 (COVID-19) pandemic changed the training pattern of urology residents during the peak of the outbreak in March 2020. We found a critical decrease in residents' activities (especially for those in their final years of residency and for surgical procedures) that, even if lower than expected, might negatively impact their education and training in the future.

4.
Minerva Urol Nephrol ; 73(3): 384-391, 2021 06.
Article in English | MEDLINE | ID: covidwho-1298271

ABSTRACT

BACKGROUND: The COVID-19 pandemic induced a global emergency that overwhelmed most hospitals around the world. Access to hospitals has been restricted to selective oncological and urgent patients to minimize surgeries requiring Intensive Care Unit care. All other kind of non-urgent and benign surgeries have been rescheduled. The burden of oncological and urgent cases on the healthcare system has increased. METHODS: We have been asked to become the referral center for major oncological and urgent urological surgeries, increasing our surgical volume. Through meticulous hospital protocols on PPE, use of nasopharyngeal swabs, controlled hospital access and the prompt management of suspected/positive cases, we were able to perform 31% more urological surgical procedures during the COVID-19 pandemic compared to the same period in 2019. RESULTS: We observed a 72% increase in oncological surgical procedures and 150% in urgent procedures. CONCLUSIONS: Our experience shows how the management of oncological and urgent cases can be maintained during unexpected, global emergencies, such as COVID-19.


Subject(s)
COVID-19 , Pandemics , Urologic Surgical Procedures/statistics & numerical data , Anesthesia , Emergency Medical Services , Humans , Italy , Nasopharynx/virology , Patient Care Team , Personal Protective Equipment , Referral and Consultation , Surgical Oncology , Telemedicine/trends , Urologic Neoplasms/surgery
5.
Urologia ; 88(4): 298-305, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1226830

ABSTRACT

INTRODUCTION: The current scenario of the COVID-19 pandemic is significantly different from that of the first, emergency phase. Several countries in the world are experiencing a second, or even a third, wave of contagion, while awaiting the effects of mass vaccination campaigns. The aim of this report was to provide an update of previously released recommendations on prioritization and restructuring of urological activities. METHODS: A large group of Italian urologists directly involved in the reorganization of their urological wards during the first and second phase of the pandemic agreed on a set of updated recommendations for current urology practice. RESULTS: The updated recommendations included strategies for the prioritization of both surgical and outpatient activities, implementation of perioperative pathways for patients scheduled for elective surgery, management of urological conditions in infected patients. Future scenarios with possible implementation of telehealth and reshaping of clinical practice following the effects of vaccination are also discussed. CONCLUSION: The present update may be a valid tool to be used in the clinical practice, may provide useful recommendations for national and international urological societies, and may be a cornerstone for further discussion on the topic, also considering further evolution of the pandemic after the recently initiated mass vaccination campaigns.


Subject(s)
COVID-19 , Urology , COVID-19 Vaccines , Humans , Immunization Programs , Pandemics , SARS-CoV-2 , Urologic Surgical Procedures
6.
Ann Surg ; 2021 Jan 22.
Article in English | MEDLINE | ID: covidwho-1045790

ABSTRACT

OBJECTIVE: To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic. SUMMARY BACKGROUND DATA: The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19. METHODS: We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the Depression Anxiety Stress Scale-21 (DASS-21) and Impact of Event Scale-Revised (IES-R) scores. RESULTS: 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9% and 24.0% screened positive for depression, anxiety, stress and Post-Traumatic Stress Disorder (PTSD) respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress and PTSD (OR 1.3, 1,6, 1.4, 1.7 respectively, all p < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress and PTSD (OR 1.2, 1.2 and 1.3 respectively, all p < 0.05). Surgical specialities that operated in the Head and Neck region had higher psychological distress among its surgeons. Deployment for COVID-19-related work was not associated with increased psychological distress. CONCLUSIONS: The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

7.
Archivos españoles de urología ; 73(5):345-352, 2020.
Article in Spanish | IBECS | ID: covidwho-1016699

ABSTRACT

La actual pandemia por COVID-19 ha requeridola implementación de medidas drásticas para frenar su avance. Las instalaciones y recursos sanitarios se están destinando de forma total o parcial para la atención de pacientes críticos. Los urólogos, nos hemos encontrado durante las semanas pasadas con cambios importantes que dificultan nuestra práctica clínica diaria. Las actividades ambulatorias como consultas externas y procedimientos ambulatorios, así como las intervenciones quirúrgicas, han tenido que ser suspendidas o retrasadas. Mientras dure esta situación, la actividad médica telemática puede proveer un soporte adecuado utilizando herramientas tecnológicas y tratando de simular las consultas médicas con vídeo llamadas o llamadas por teléfono. Pero muchos servicios y departamentos médico-quirúrgicos no se encuentran listos para implementar una práctica de consultas telemáticas a gran escala porque su experiencia es escasa. Los beneficios de la telemedicina en urología son permitir el seguimiento de pacientes, dar recomendaciones, prescribir medicamentos, y realizar un triaje de qué pacientes precisan una atención presencial en urgencias. Los programas de formación de residentes de urología también han sufrido una interrupción importante de sus actividades cotidianas, ya que se han suspendido consultas, cirugías y actividad académica. En esta situación, el uso de recursos virtuales y el "aprendizaje inteligente"se están utilizando para mantener la docencia. El objetivo de este artículo es proporcionar una revisión de la más reciente literatura acerca del uso de telemedicina en la práctica urológica moderna, con nuestras recomendaciones y conclusiones The COVID-19 pandemic has required drastic measures for an attempt in controlling its spread. Health resources and facilities are being destined for the treatment of critically ill infected patients. During the past weeks, we, as urologists have faced increasingly difficult changes in practice, as outpatient activity and elective surgeries must be postponed in order to save resources and limit the mobilization of patients and faculty. During this conflictive situation, telehealth medicine can provide adequate support using technological tools and trying to simulate face-to-face consults with the use of video or telephone calls. However, many outpatient clinics and facilities are not ready yet for telehealth as their experience in this area is low. The benefits for telemedicine in urology are continuing urologic outpatient follow-up, providing recommendations and prescriptions, and the triage of patients who will need urgent procedures. Urology residency training has suffered an abrupt disruption nowadays as outpatient, surgical and academic meetings are cancelled. In this scenario, virtual strategies and "smart learning"activities are being used to continue education. We provide a review of the latest published literature regarding the use of telehealth medicine or telemedicine for the modern urology practice, alongside our recommendations and conclusions

8.
Int. braz. j. urol ; 46(supl.1):39-49, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742942

ABSTRACT

ABSTRACT Purpose: To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. Materials and Methods: A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. Results: Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. Conclusions: categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.

9.
Int. braz. j. urol ; 46(supl.1):170-180, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742329

ABSTRACT

ABSTRACT Purpose: to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. Materials and Methods: In May the 6th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents'activity. A narrative summary of guidelines and current literature for each point of interest was performed. Conclusion: In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.

10.
Int. braz. j. urol ; 46(supl.1):26-33, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742328

ABSTRACT

ABSTRACT The COVID-19 pandemic has impacted our lives, our habits and our healthcare system. Italy is one of the countries affected first and more aggressively from the outbreak. Our rapidity has been guide for other healthcare systems from around the World. We describe the impact of COVID-19 on Urology, how the Urological scientific community responded to the emergency and our experience in a high-volume Roman University hospital. The aim of our work is to share our experience providing suggestions for other global hospitals on how to manage the COVID-19 emergency.

11.
Int. braz. j. urol ; 46(supl.1):62-68, 2020.
Article in English | LILACS (Americas), Grey literature | ID: grc-742327

ABSTRACT

ABSTRACT The COVID-19 outbreak has led to the deferral of a great number of surgeries in an attempt to reduce transmission of infection, free up hospital beds, intensive care and anaesthetists, and limit aerosol-generating procedures. Guidelines and suggestions have been provided to categorize Urological diseases into risk groups and recommendations are available on procedures that can be or cannot be deferred. We aim to summarise updates on diagnosis, treatment and follow up of bladder cancer during the COVID-19 outbreaks.

12.
Clin Genitourin Cancer ; 19(2): e63-e68, 2021 04.
Article in English | MEDLINE | ID: covidwho-652586

ABSTRACT

PURPOSE: To investigate the health-related quality of life of uro-oncologic patients whose surgery was postponed without being rescheduled during the coronavirus disease 2019 (COVID-19) pandemic. PATIENTS AND METHODS: From the March 1 to April 26, 2020, major urologic surgeries were drastically reduced at our tertiary-care referral hospital. In order to evaluate health-related quality-of-life outcomes, the SF-36 questionnaire was sent to all patients scheduled for major surgery at our department 3 weeks after the cancellation of the planned surgical procedures because of the COVID-19 emergency. RESULTS: All patients included in the analysis had been awaiting surgery for a median (interquartile range) time of 52.85 (35-72) days. The SF-36 questionnaire measured 8 domains: physical functioning (PF), role limitations due to physical health (PH), role limitations due to emotional problems (RE), energy/fatigue (EF), emotional well-being (EWB), social functioning (SF), bodily pain (BP), general health perceptions (GHP). When considering physical characteristics as measured by the SF-36 questionnaire, PF was 91.5 (50-100) and PH was 82.75 (50-100) with a BP of 79.56 (45-90). For emotional and social aspects, RE was 36.83 (0-100) with a SF of 37.98 (12.5-90). Most patients reported loss of energy (EF 35.28 [15-55]) and increased anxiety (EWB 47.18 [interquartile range, 20-75]). All patients perceived a reduction of their health conditions, with GHP of 49.47 (15-85). Generally, 86% of patients (n = 43) noted an almost intact physical function but a significant emotional alteration characterized by a prevalence of anxiety and loss of energy. CONCLUSION: The lockdown due to the novel coronavirus that has affected most operating rooms in Italy could be responsible for the increased anxiety and decrement in health status of oncologic patients. Without any effective solution, we should expect a new medical catastrophe-one caused by the increased risk of tumor progression and mortality in uro-oncologic patients.


Subject(s)
COVID-19/prevention & control , Pandemics/prevention & control , Quality of Life , Urologic Neoplasms/psychology , Urologic Surgical Procedures/psychology , Aged , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/etiology , Anxiety/psychology , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Communicable Disease Control , Female , Health Status , Humans , Italy/epidemiology , Male , Middle Aged , Operating Rooms/standards , Operating Rooms/statistics & numerical data , SARS-CoV-2/pathogenicity , Self Report/statistics & numerical data , Time-to-Treatment/statistics & numerical data , Urologic Neoplasms/surgery , Urologic Surgical Procedures/standards , Urologic Surgical Procedures/statistics & numerical data
13.
Minerva Urol Nefrol ; 72(3): 387-388, 2020 06.
Article in English | MEDLINE | ID: covidwho-729821
14.
Int Braz J Urol ; 46(suppl.1): 170-180, 2020 07.
Article in English | MEDLINE | ID: covidwho-639402

ABSTRACT

PURPOSE: to provide an update on the management of a Urology Department during the COVID-19 outbreak, suggesting strategies to optimize assistance to the patients, to implement telemedicine and triage protocols, to define pathways for hospital access, to reduce risk of contagious inside the hospital and to determine the role of residents during the pandemic. MATERIALS AND METHODS: In May the 6th 2020 we performed a review of the literature through online search engines (PubMed, Web of Science and Science Direct). We looked at recommendations provided by the EAU and ERUS regarding the management of urological patients during the COVID-19 pandemic. The main aspects of interest were: the definition of deferrable and non-deferrable procedures, Personal Protective Equipment (PPE) and hospital protocols for health care providers, triage, hospitalization and surgery, post-operative care training and residents' activity. A narrative summary of guidelines and current literature for each point of interest was performed. CONCLUSION: In the actual Covid-19 scenario, while the number of positive patients globally keep on rising, it is fundamental to embrace a new way to deliver healthcare and to overcome challenges of physical distancing and self-isolation. The use of appropriate PPE, definite pathways to access the hospital, the implementation of telemedicine protocols can represent effective strategies to carry on delivering healthcare.


Subject(s)
Coronavirus Infections , Pandemics , Personal Protective Equipment , Pneumonia, Viral , Practice Guidelines as Topic , Urology/organization & administration , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Humans , Interprofessional Relations , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Telemedicine
15.
Minerva Urol Nefrol ; 20200622.
Article in English | WHO COVID, ELSEVIER | ID: covidwho-611285

ABSTRACT

The COVID-19 pandemic induced a global emergency that overwhelmed most hospitals around the world. Access to Hospitals has been restricted to selective oncological and urgent patients to minimize surgeries requiring Intensive Care Unit care. All other kind of non- urgent and benign surgeries have been rescheduled. The burden of oncological and urgent cases on the healthcare system has increased. We have been asked to become the referral center for major oncological and urgent urological surgeries, increasing our surgical volume. Through meticulous hospital protocols on PPE, use of nasopharyngeal swabs, controlled hospital access and the prompt management of suspected/positive cases, we were able to perform 31% more urological surgical procedures during the COVID-19 pandemic compared to the same period in 2019. We observed a 72% increase in oncological surgical procedures and 150% in urgent procedures. Our experience shows how the management of oncological and urgent cases can be maintained during unexpected, global emergencies, such as COVID-19.

16.
Int Braz J Urol ; 46(suppl.1): 26-33, 2020 07.
Article in English | MEDLINE | ID: covidwho-611614

ABSTRACT

The COVID-19 pandemic has impacted our lives, our habits and our healthcare system. Italy is one of the countries affected first and more aggressively from the outbreak. Our rapidity has been guide for other healthcare systems from around the World. We describe the impact of COVID-19 on Urology, how the Urological scientific community responded to the emergency and our experience in a high-volume Roman University hospital. The aim of our work is to share our experience providing suggestions for other global hospitals on how to manage the COVID-19 emergency.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Urology/trends , Betacoronavirus , COVID-19 , Hospitals , Humans , Italy , Pandemics , SARS-CoV-2
17.
Int Braz J Urol ; 46(suppl.1): 39-49, 2020 07.
Article in English | MEDLINE | ID: covidwho-611611

ABSTRACT

PURPOSE: To provide recommendations on the endourological management of lithiasis in the scenario of the COVID-19 pandemic. MATERIALS AND METHODS: A non-systematic review in PubMed and the grey literature, as well as recommendations by a panel of stakeholders was made, regarding management, surgical considerations and follow-up of patients affected by lithiasis in the COVID-19 era. RESULTS: Under the current outbreak and COVID-19 pandemic scenario, patients affected by lithiasis should be prioritized into low, intermediate and high risk categories, to decide their delay and save resources, healthcare personnel, beds and ventilators. However, patients with potentially serious septic complications need emergency interventions. The possibility of performing or restarting elective activity depends on local conditions, the availability of beds and ventilators, and the implementation of screening protocols in the context of the COVID-19 pandemic. Delaying lithiasis surgery and increasing waiting lists will have consequences and will require considerable additional effort. Teleconsultation may be useful in guiding these patients, reducing visits and unnecessary exposure. CONCLUSIONS: categorization and prioritization of patients affected by lithiasis is crucial for management, surgical selection and follow-up. Protocols, measures and additional efforts should be carried out in the current situation of the COVID-19 pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Lithiasis/therapy , Pneumonia, Viral/epidemiology , Urology/methods , Betacoronavirus , COVID-19 , Follow-Up Studies , Humans , Pandemics , SARS-CoV-2
18.
Eur Urol ; 78(6): 786-811, 2020 12.
Article in English | MEDLINE | ID: covidwho-603742

ABSTRACT

CONTEXT: Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse. OBJECTIVE: To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth. EVIDENCE ACQUISITION: After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed. EVIDENCE SYNTHESIS: We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good. CONCLUSIONS: Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary. PATIENT SUMMARY: The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.


Subject(s)
COVID-19/epidemiology , Pandemics , Prostatic Neoplasms/therapy , Telemedicine , Urology , Decision Making , Hematuria/etiology , Humans , Male , Pelvic Organ Prolapse/therapy , Prostatic Neoplasms/pathology , SARS-CoV-2 , Urinary Calculi/diagnosis , Urinary Calculi/therapy , Urinary Incontinence/therapy , Urinary Tract Infections/drug therapy
19.
Archivos espanoles de urologia ; 73(5):345-352, 2020.
Article | WHO COVID | ID: covidwho-601779

ABSTRACT

The COVID-19 pandemic has requiredd rastic measures for an attempt in controlling its spread. Health resources and facilities are being destined for the treatment of critically ill infected patients. During the past weeks, we, as urologists have faced increasingly difficult changes in practice, as out patient activity andelective surgeries must be postponed in order to save resources and limit the mobilization of patients and faculty. During this conflictive situation, telehealth medicine can provide adequate support using technological tools and trying to simulate face-to-face consults with the use of video or telephone calls. However, many out patient clinics and facilities are not ready yet for telehealth as their experience in this area is low. The benefits for telemedicine in urology are continuing urologic outpatient follow-up, providing recommendations and prescriptions, and the triage of patients who will need urgent procedures. Urology residency training has suffered an abrupt disruption nowadays as outpatient, surgical and academic meetings are cancelled. In this scenario, virtual strategies and "smart learning" activities are being used to continue education. We provide a review of the latest published literature regarding the use of telehealth medicine or telemedicine for the modern urology practice, along side our recommendations and conclusions. La actual pandemia por COVID-19 ha requeridola implementacion de medidas drasticas para frenar su avance. Las instalaciones y recursos sanitarios se estan destinando de forma total o parcial para la atencion de pacientes criticos. Los urologos, nos hemos encontrado durante las semanas pasadas con cambios importantes que dificultan nuestra practica clinica diaria. Las actividades ambulatorias como consultas externas y procedimientos ambulatorios, asi como las intervenciones quirurgicas, han tenido que ser suspendidas o retrasadas. Mientras dure esta situacion, la actividad medica telematica puede proveer un soporte adecuado utilizando herramientas tecnologicas y tratando de simular las consultas medicas con video llamadas o llamadas por telefono. Pero muchos servicios y departamentos medico-quirurgicos no se encuentran listos para implementar una practica de consultas telematicas a gran escala porque su experiencia es escasa. Los beneficios de la telemedicina en urologia son permitir el seguimiento de pacientes, dar recomendaciones, prescribir medicamentos, y realizar un triaje de que pacientes precisan una atencion presencial en urgencias. Los programas de formacion de residentes de urologia tambien han sufrido una interrupcion importante de sus actividades cotidianas, ya que se han suspendido consultas, cirugias y actividad academica. En esta situacion, el uso de recursos virtuales y el aprendizaje inteligente se estan utilizando para mantener la docencia. El objetivo de este articulo es proporcionar una revision de la mas reciente literatura acerca del uso de telemedicina en la practica urologica moderna, con nuestras recomendaciones y conclusiones.

20.
Archivos espanoles de urologia ; 73(5):345-352, 2020.
Article | WHO COVID | ID: covidwho-601778

ABSTRACT

The COVID-19 pandemic has requiredd rastic measures for an attempt in controlling its spread. Health resources and facilities are being destined for the treatment of critically ill infected patients. During the past weeks, we, as urologists have faced increasingly difficult changes in practice, as out patient activity and elective surgeries must be postponed in order to save resources and limit the mobilization of patients and faculty. During this conflictive situation, telehealth medicine can provide adequate support using technological tools and trying to simulate face-to-face consults with the use of video or telephone calls. However, many out patient clinics and facilities are not ready yet for telehealth as their experience in this area is low. The benefits for telemedicine in urology are continuing urologic outpatient follow-up, providing recommendations and prescriptions, and the triage of patients who will need urgent procedures. Urology residency training has suffered an abrupt disruption nowadays as outpatient, surgical and academic meetings are cancelled. In this scenario, virtual strategies and "smart learning" activities are being used to continue education. We provide a review of the latest published literature regarding the use of telehealth medicine or telemedicine for the modern urology practice, along side our recommendations and conclusions.

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