ABSTRACT
BACKGROUND: To evaluate the impact of COVID-19 lockdown on non-COVID urological patient's management in tertiary care urology centres. METHODS: This is an observational study in which data of patients visiting the urology department of all the MCGM run tertiary care hospitals were recorded for the duration of 1 April 2020 to 31 July 2020 and were compared to data of pre-COVID-19 period of similar duration. RESULTS: There was a decrease of 93.86% in indoor admissions of urology patients during the COVID-19 lockdown. Indoor admissions for stone disease, haematuria, malignancy accounted for 53.65%, 15.85%, 9.75%, respectively. Elective surgeries had the highest percentage decrease followed by emergency and semi-emergency procedures. There was a reduction of more than 80% in patients attending outpatient clinics. Stone disease and its consequences were the main reasons for visiting outdoor clinics (39%). A substantial number of patients presented with flank and abdominal pain (14.8%) and benign enlargement of the prostate (10.23%). Malignancy accounted for a very small number of patients visiting outdoor clinics (1.58%). CONCLUSIONS: COVID-19 pandemic has a profound impact on patient care and education in Urology. There was more than ninety percent reduction in indoor admissions, operative procedures, and outpatient clinics attendance. Once the pandemic is controlled, there will be a large number of patients seeking consultation and management for urological conditions and we should be prepared for it. Surgical training of urology residents needs to be compensated in near future. Long-term impact on urological patient outcome remains to be defined.
ABSTRACT
This is a case report of emphysematous cystitis with spontaneous intraperitoneal bladder perforation in postoperative period of pedicle fixation surgery for prolapse intervertebral disc (L3-L4). The patient developed urinary retention with overflow incontinence with abdominal tenderness and fever 3 days after orthopedic procedure which on computed tomography (CT) scan found to have abundant air in urinary bladder with multiple air foci in bladder wall with suspected leak into intraperitoneal pelvic cavity, proven only after CT cystogram.
ABSTRACT
BACKGROUND: An unrecognized, or occult, injury is particularly dangerous in trauma patients, who often have multiple life-threatening injuries. We sought to determine the frequency and quantify the utility of the abdominal computed tomographic (CT) scan in detecting occult pneumothoraces. METHODS: Charts of all trauma patients diagnosed with a pneumothorax over a 7-year period were retrospectively reviewed for findings on admission chest radiograph, abdominal CT scan, and other demographic data. RESULTS: A total of 312 charts were reviewed, with 230 patients identified as having a pneumothorax at admission. Of the 230 patients, 126 (54.8%) had an occult pneumothorax identified on abdominal CT scan. In these patients, the mean Trauma Score was 14.1 +/- 2.9 and the mean Injury Severity Score was 24.1 +/- 11.2. In the group of occult pneumothoraces, 84 (66.7%) underwent chest tube placement. CONCLUSIONS: Abdominal CT scanning provided important information about thoracic trauma often missed on initial evaluation in the trauma bay. This information frequently affected the patient's clinical management.
