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1.
World J Urol ; 40(1): 277-282, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1391852

ABSTRACT

PURPOSE: To evaluate the impact of COVID-19 pandemic on functional urology procedures in France. METHODS: A prospective study was conducted within 11 secondary and tertiary referral centers in France. Patients aged > 18 years who were diagnosed with a functional urology disease before the national lockdown (March 17th, 2020) and who required a surgery were included. Study period went from March 17th to September 30th 2020. The included interventions were listed according to the guidelines for functional urology enacted by the French Association of Urology and delay of reoperation was compared to the guidelines' delay. The primary outcome was the number of procedures left unscheduled at the end of the study period. Descriptive statistics were performed. RESULTS: From March 17th 2020 to September 3 rd 2020, 1246 patients with a previous diagnosis of a functional urological disease requiring a surgery were included. The mean follow-up was 140.4 days (± 53.4). Overall, 316 interventions (25.4%) were maintained whereas 74 (5.9%) were canceled, 848 (68.1%) postponed and 8 patients (0.6%) died. At the end of the follow-up, 184 patients (21.7%) were still not rescheduled. If the intervention was postponed, the mean delay between the initial and final date was 85.7 days (± 64.4). CONCLUSION: Overall, more than two thirds of interventions had to be postponed and the mean delay between the initial and final date was about three months.


Subject(s)
COVID-19/epidemiology , Time-to-Treatment/statistics & numerical data , Urologic Diseases/surgery , Urologic Surgical Procedures/statistics & numerical data , Adult , Aged , COVID-19/prevention & control , COVID-19/transmission , Communicable Disease Control , Female , France , Humans , Male , Middle Aged , Patient Selection , Prospective Studies , Time Factors , Triage , Urologic Diseases/diagnosis , Urologic Diseases/mortality
2.
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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