Changing urological practice during COVID-19

Devana, Sudheer Kumar; Chaudhary, Kapil; Sharma, Aditya; Singh, Shrawan Kumar

doi:10.4103/iju.iju_269_20

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…Patients presenting with urological injuries related to obstetrics and gynaecological procedures had the least decrease in number as they were given priority for transport, diagnosis, and management. Studies done by Devana SK et al, Teoh JY et al, Prasad N et al showed similar reductions in various urological procedures [ 6 – 8 ]. Similar findings were noted with regard to patients presenting to outpatient clinics.…”

Section: Discussionmentioning

confidence: 79%

Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 79%

Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

et al. 2021

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“…Bansal et al 11 reported a decline of 87.7, 70.7, and 76% in uro-oncologic, renal transplants, and other urological procedures performed during lockdown compared with a similar duration in 2019 at a tertiary care center in India. Devana et al 12 in a similar study from a tertiary care center in India showed that during the pandemic the urological procedure reduced to 13.58% compared to pre-lockdown, in which all cases performed were emergencies out of which TURBT was the most common performed procedure (70.4%).…”

Section: Discussionmentioning

confidence: 98%

Do Uro-Oncology Day Care Procedures Need to Be Differed during COVID-19 Pandemic?—An Experience from Tertiary Cancer Care Center

Srivastava,

Pal,

Prakash

et al. 2024

South Asian J Cancer

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Background: The SARS-CoV-2 virus pandemic has affected millions all over the world in very short span and changed the way how health care system work across the globe. It is essential to continue cancer treatment in spite of such pandemics. Various recommendations were proposed for cancer management based on risk stratification, however, in urological malignancies, day care procedures (DCPs) are a part of complete spectrum of cancer care and standard operating procedures (SOPs) for day care procedures (DCPs)in oncology is lacking at present. Material and Methods: This is an institutional review board approved retrospective observational analytical study performed in tertiary cancer care center, with aim to assess the impact of COVID-19 on Uro-oncology day care procedures (U-DCPs)in terms of changes in appointments and actual U-DCPs performed, demographic changes such as sex ratio and age wise attendance in pre and post lockdown period and to provide a SOPs to accomplishU-DCPsefficiently in pandemics. Result: There was 67.89% and 68.16% reduction in total numbers of appointment and performed U-DCPs. A statistically significant difference was found in cystoscopy, intravesicalinstallation and miscellaneous UDCPs. Overall, 4.45% reduction and 4.52% increase in male and female patients underwent UDCPs respectively, M:F ratio reduced from 3.58:1 to 2.79:1 and 30% to 50% reduction in overall patient statistics in post lockdown compare to pre lockdown procedures.For various age groups there was a statistically significant change in the number for males underwent cystoscopy in (p<0.001), Intravesical therapies (p<0.001) and miscellaneous procedures(p< 0.004). Conclusion: We are now coming up to the fact that effective management of healthcare system during pandemics require establishment and effective implementation of standard protocols. Routine major urological surgical care is continued using a tiered standard of protocols (SOPs) and adequate precautions. This study may provide an insight into impact of COVID-19 on UDCPs and what precautions and strategies can be institutionalized so that the patients and the health care workers remain protected from contracting infection while in performing DCPs during pandemic or similar circumstances.

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“…The most significant healthcare shift has been in the operational elements of medical institutions [ 4 ]. As a result, the majority of outpatient appointments and procedures have been postponed, frequently without any preplanned patient or pathology-related methods, while medical practitioners have been recruited from their regular specialized medical field to practice COVID-oriented medicine [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of the Challenges of Urothelial Cancer Management during the COVID-19 Pandemic at a Single Academic Center in Romania

Barbos

Feciche²,

Bratosin

et al. 2023

Healthcare

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The COVID-19 pandemic caused major changes in the healthcare sector due to adaptations required to hospitalize and treat an impressive number of patients. This retrospective study intended to collect reliable information on urothelial cancer patients in Romania. The primary objective was to compare the pre-pandemic and pandemic periods to observe the differences that occurred in the management of patients with urothelial carcinoma. The secondary objective was to determine the risk factors for urothelial cancer progression in the study cohort correlated with the COVID-19 pandemic. All patients that were diagnosed and treated at our clinic with a diagnosis of urothelial carcinoma (transitional cell carcinoma) during 2019–2021 were included in the current study. A total of 1122 eligible unique cases were identified during the study period. The number of patients who underwent intervention in the pre-pandemic year was 421, followed by a 22.6% decrease in 2020 to 326 cases and a 13.1% increase in 2021 to 375 cases. The proportion of muscle-invasive bladder cancer (MIBC) cases was significantly higher during the pandemic years, from 30.5% MIBC cases in 2019 to 37.4% in 2020 and 39.4% in 2021, suggesting a delay in presentations during the pandemic. Stage III and IV (TNM) cases were significantly more frequent, even though approximately 40% of all patients were operated on in stage I. The number of cystectomies increased significantly, from 5.2% in 2019 and 4.3% in 2020 to 10.1% in 2021, while the number of elective surgeries decreased, although no significant difference was observed regarding the in-hospital mortality and disease progression at six months. Patients with stage III and IV at presentation had the highest likelihood of disease progression at six months (HR = 5.61). Distant invasion was the second highest risk factor (HR = 5.13), followed by MIBC type (HR = 2.49). Nevertheless, the duration of hospitalization and year of diagnosis during the COVID-19 pandemic were not significant risk factors for cancer progression at six months. It can be concluded that there was a significant delay in patient presentations in 2020, and we advocate for increased public health awareness for urothelial cancer and increased attention toward the screening and management of these patients in the following years.

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Changing urological practice during COVID-19

Cited by 7 publications

References 27 publications

Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

Impact of COVID-19 pandemic on non-COVID patient’s management in urology: a public hospital experience in Mumbai

Do Uro-Oncology Day Care Procedures Need to Be Differed during COVID-19 Pandemic?—An Experience from Tertiary Cancer Care Center

A Retrospective Analysis of the Challenges of Urothelial Cancer Management during the COVID-19 Pandemic at a Single Academic Center in Romania

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