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BMJ Case Rep ; 14(3)2021 Mar 02.
Article in English | MEDLINE | ID: covidwho-1115111


We describe a case of retrovesical liposarcoma in a male patient with concurrent COVID-19. A 50-year-old man had lower urinary tract symptoms and dull pain along his right gluteus. Due to COVID-19 infection, management was delayed. During self-isolation, the patient developed urinary retention and his pain level was an eight on the Visual Analogue Scale. A urinary catheter and an epidural catheter were inserted without any difficulty. Abdominal-pelvic MRI revealed a retrovesical mass suspected of liposarcoma with clear borders from surrounding organs. Following two consecutive negative SARS-CoV-2 PCR tests, we proceeded with surgery. Histopathology was dedifferentiated liposarcoma. Postoperatively, the patient suffered reactivation of COVID-19, and he was eventually discharged after two consecutive negative results on the PCR test on Post Operative Day (POD)-10. Retrovesical dedifferentiated liposarcoma is rare and considered as high-grade liposarcoma. Although surgery may exacerbate COVID-19 infection, surgical resection of symptomatic high-grade sarcoma is prioritised and performed as soon as no infection detected.

COVID-19/diagnosis , Liposarcoma , Lower Urinary Tract Symptoms , Pelvic Neoplasms , SARS-CoV-2/isolation & purification , Surgical Procedures, Operative/methods , Urinary Retention , COVID-19/therapy , Chemoradiotherapy, Adjuvant/methods , Dissection/methods , Humans , Liposarcoma/pathology , Liposarcoma/physiopathology , Lower Urinary Tract Symptoms/diagnosis , Lower Urinary Tract Symptoms/etiology , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neoplasm Grading , Pelvic Neoplasms/pathology , Pelvic Neoplasms/physiopathology , Time-to-Treatment , Treatment Outcome , Urinary Retention/diagnosis , Urinary Retention/etiology
Urol Int ; 104(7-8): 631-636, 2020.
Article in English | MEDLINE | ID: covidwho-326997


PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS: A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS: Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION: In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.

Coronavirus Infections/epidemiology , Health Services Accessibility/trends , Pneumonia, Viral/epidemiology , Urology/trends , Ambulatory Care , Betacoronavirus , COVID-19 , Disease Outbreaks , Hospitals/statistics & numerical data , Humans , Italy/epidemiology , Pandemics , Regression Analysis , SARS-CoV-2 , Surveys and Questionnaires , Urologic Diseases/epidemiology , Urologic Diseases/therapy , Urology/methods