Implementation and strategies to ensure adequate coordination within a Urology Department during the COVID-19 pandemic

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 6 th 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.

The Impact of the COVID-19 Pandemic on Urology Residents: a Narrative Review

“…In Europe, urology residents were also redeployed to other front-line services [ 10 , 11 ]. In Italy, 8% of residents worked in non-urology units [ 12 ].…”

“…In response to the COVID-19 pandemic, hospital departments worldwide limited procedures to urgent and non-deferrable cases [ 11 ]. Furthermore, to minimize exposure, unnecessary use of PPE, reduce operative times, and minimize the possibility of complications, senior surgeons and attendings have been encouraged to perform the majority of cases and often without the assistance of residents [ 15 ].…”

New Technologies for Kidney Surgery Planning 3D, Impression, Augmented Reality 3D, Reconstruction: Current Realities and Expectations

“…A lower exposure of residents to major procedures, as well as for novice inexperienced surgeons, is leading to poor satisfaction of surgical training and lower confidence performing surgeries independently [33]. Moreover, COVID-19 pandemic has rapidly affected surgical training due to the substantial decrease in election procedures in favor of urgent cases [34][35][36][37]. In this scenario, surgical training in urology may suffer more than before, and pursuing innovation in learning surgeries needs to be a cornerstone of trainees education that, with new tools, could even be implemented [38].…”

Impact of COVID-19 on a urology residency program

“…Although the majority of ill patients do not need hospital care, as much as 5% require intensive care for days until weeks (5). The huge numbers of patients seeking medical attention at the same time and monopolizing hospital facilities caused a shift in the healthcare system's focus towards critically ill patients (6)(7)(8).…”