Urology during a Crisis: A Management Algorithm
Urology Journal,
Vol. 17 No. 05 (2020),
30 October 2020
,
Page 536-539
https://doi.org/10.22037/uj.v17i05.6278
Abstract
COVID-19 pandemic has affected more than a million people worldwide causing a public health crisis. Under these unique circumstances, urologists continue to provide essential healthcare services and support healthcare systems, by participating in the treatment of COVID-19(+) patients and sparing vital equipment and hospital beds. However, delivering medical care during the pandemic requires strategic planning for all surgical and outpatient activities. Proposed measures include rescheduling elective non-oncological surgeries and using a prioritization protocol for oncological surgeries according to hospital capacity. Following that, outpatient clinics could be partly replaced by telemedicine. Additionally, urologists should be trained in screening and treating patients with COVID-19 during their daily routine. In order to efficiently provide their services, a management protocol for suspected or known COVID-19 urological patients should be implemented. Furthermore, preventive measures for the nosocomial dispersion of the virus and training on self-protective equipment is mandatory for all physicians. Finally, organizational planning for the best utilization of the staff is of utmost importance. Implementation and adaptation of the protocols according to local requirements and guidelines will ameliorate the quality of services and population’s health status. Finally, enhancement of current practices will prepare health systems for future crisis.
- COVID-19
- urological patients
- management protocol
- prioritization of surgeries
How to Cite
References
WHO Coronavirus disease 2019 (COVID-19). Situation Report – 123. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200522-covid-19-sitrep-123.pdf?sfvrsn=5ad1bc3_4 Accessed 23 May 2020
Qin Q, Wang Y, Wang Y, et al. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. 2020;0-1. doi:10.1002/jmv.25748
World Health Organisation. Operational guidance for maintaining essential health services during an outbreak. 2020;(March):1-14.
Damery S, Wilson S, Draper H, et al. Will the NHS continue to function in an influenza pandemic? A survey of healthcare workers in the West Midlands, UK. BMC Public Health 2009; 9:142 https://doi.org/10.1186/1471-2458-9-142
Iacobucci G. Covid-19 : all non-urgent elective surgery is suspended for at least three months in England. 2020;1106(March):18-19. doi:10.1136/bmj.m1106
Akladios C, Azais H, Ballester M, et al. Recommandations pour la prise en charge chirurgicale des cancers gynécologiques en période de pandémie COVID-19 – Groupe FRANCOGYN pour le CNGOF [Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period - FRANCOGYN group for the CNGOF] [published online ahead of print, 2020 Mar 25]. Gynecol Obstet Fertil Senol. 2020;S2468-7189(20)30130-6. doi:10.1016/j.gofs.2020.03.017
Ueda M, Martins R, Hendrie PC, et al. Managing Cancer Care During the COVID-19 Pandemic : Agility and Collaboration Toward a Common Goal. 2020;18(4):1-4. doi:10.6004/jnccn.2020.7560
Proietti S, Hospital SR, Division VT, et al. European Urology Endourological Stone Management in the Era of the COVID-19. EURUROL-D-20-00386R1. https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/eururo/EURUROL-D-20-00386_R1-1585252056623.pdf Accessed 26 April 2020
Zhou F, Yu T, Du R et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054–62. DOI:https://doi.org/10.1016/S0140-6736(20)30566-3
Delmas V, Schulman C. European Urology. CONSIDERATIONS IN THE TRIAGE OF UROLOGIC SURGERIES DURING THE COVID-19 PANDEMIC. EURUROL-D-20-00380 https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/eururo/EURUROL-D-20-00380-1584548684213.pdf. Accessed 26 April 2020
Mottrie A. ERUS (EAU Robotic Urology Section) guidelines during COVID-19 emergency. March. 2020. https://uroweb.org/wp-content/uploads/ERUS-guidelines-for-COVID-def.pdf. Accessed 26 April 2020
Adhikari SP, Meng S, Wu Y, et al. A literature review of 2019 Novel Coronavirus during the early outbreak period: Epidemiology, causes, clinical manifestation and diagnosis, prevention and control. Infect Dis Poverty. 2020;9(29):1-12. doi: 10.20944/preprints202002.0060.v1
Hollander JE, Carr BG. Virtually Perfect? Telemedicine for Covid-19. N Engl J Med. March 2020; doi:10.1056/NEJMp2003539
Al-Tawfiq JA, Hinedi K, Ghandour J, et al. Middle East respiratory syndrome coronavirus: a case-control study of hospitalized patients. Clin Infect Dis. 2014;59:160-5.
Chen G, Zhu L, et al. European Urology Coronavirus Disease 2019 Pneumonia in Immunosuppressed Renal Transplant Recipients : A Summary of 10 Confirmed Cases in Wuhan , China. 2019. EURUROL-D-20-00406. https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/eururo/EURUROL-D-20-00406-1584986939537.pd. Accessed 29 April 2020
Liang W, Guan W, Chen R, Wang W, Li J, Xu K, Li C, Ai Q, Lu W, Liang H, Li S, He J. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-33 DOI:https://doi.org/10.1016/S1470-2045(20)30096-6
Connor MJ, Winkler M, Miah S. COVID-19 Pandemic - Is Virtual Urology Clinic the answer to keeping the cancer pathway moving? BJU Int. 2020. doi:10.1111/bju.15061
Vaira LA, Salzano G, Deiana G, De Riu G. Anosmia and ageusia: common findings in COVID-19 patients [published online ahead of print, 2020 Apr 1]. Laryngoscope. 2020;10.1002/lary.28692. doi:10.1002/lary.28692
Rocco B, Sighinolfi MC, Mussini C. COVID-19: importance of the awareness of clinical syndrome by urologists. Eur Urol. 2020; EURUROL-D-20-00385 Retrieved online from: https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/eururo/EURUROL-D-20-00385-1584548688917.pdf. Accessed 4 May 2020
Chan JF-W, Yip CC-Y, To KK-W, et al. Improved molecular diagnosis of COVID-19 by the novel, highly sensitive and specific COVID-19-RdRp/Hel real-time reverse transcription-polymerase chain reaction assay validated in vitro and with clinical specimens. J Clin Microbiol. March 2020;JCM.00310-20. doi:10.1128/JCM.00310-20
Cascella M, Rajnik M, Cuomo A, et al. Features, Evaluation and Treatment Coronavirus (COVID-19) [Updated 2020 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554776/. Accessed 5 May 2020.
Ye Z, Zhang Y, Wang Y, Huang Z, Song B. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020;2019(37):1-9. doi:10.1007/s00330-020-06801-0
Centers for Disease Control and Prevention. U.S. Department of Health &Human Services. Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19) Retrieved online from: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html. Accessed 5 May 2020
Manjunath AS, Hofer MD. Urologic Emergencies. Med Clin North Am. 2018;102(2):373–385. doi:10.1016/j.mcna.2017.10.013
Tu C, Catto J. Platinum Priority – Guidelines EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. 2016;69:468-474. doi:10.1016/j.eururo.2015.07.040
Bonkat G, Pickard R, Bartoletti R, et al. European Association of urology guidelines on urological infections. http://uroweb.org/guideline/urological-infections. Accessed 6 May 2020
Carrion A, Anna MD, Luque P, Alcaraz AFA. Office stent placement under local anesthesia is a safe and efficient procedure for the management of multiple ureteral disorders 2017;42(2), 126–132. doi:10.1016/j.acuro.2017.06.006
Nourparvar P, Leung A, Shrewsberry AB, et al. Safety and Efficacy of Ureteral Stent Placement at the Bedside Using Local Anesthesia. J Urol. 2016;195(6):1886–1890. doi:10.1016/j.juro.2015.11.083
Wagenlehner FME, Lichtenstern C, Rolfes C, et al. Diagnosis and management for urosepsis. 2013;963-970. doi:10.1111/iju.12200
Shabeena KS, Bhargava R, Manzoor MAP, Mujeeburahiman M. Characteristics of bacterial colonization after indwelling double-J ureteral stents for different time duration. Urol Ann. 2018;10(1):71–75. doi:10.4103/UA.UA_158_17
Misrai V, Pasteur C, Ploussard G, Catto JFW. European Urology The Use of Nonsteroidal Anti-inflammatory Drugs in Urological Practice in the COVID-19 Era: Is “Safe Better than Sorry”? EURUROL-D-20-00416, https://els-jbs-prod-cdn.jbs.elsevierhealth.com/pb/assets/raw/Health%20Advance/journals/ eururo/EURUROL-D-20-00416-1585252059337.pdf. Accessed 6 May 2020.
Centers for Disease Control and Prevention. U.S. Department of Health &Human Services. Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. Retrieved online from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Accessed 6 May 2020
UK government. COVID-19: guidance for health professionals. https://www.gov.uk/government/collections/wuhan-novel-coronavirus#guidance. Accessed 6 May 2020.
WHO. Coronavirus disease 2019, Technical guidance for Health Workers. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/health-workers. Accessed 7 May 2020.
- Abstract Viewed: 487 times
- 6278 Downloaded: 200 times