The Impact of COVID-19 Disease on Urology Practice

Abstract

The diagnosis and timely treatment of cancer patients should not be compromised during an infectious disease pandemic. The pandemic of coronavirus disease 2019 (COVID-19) has serious implications on urology practice and raises particular questions for urologists about the management of different conditions. It was recommended to cancel most of the elective urological surgeries. Urological cancers surgeries that should be prioritized are radical cystectomy for selective tumors, orchiectomy for suspected testicular tumors, nephrectomy for c T3 + , nephroureterectomy for high-grade disease, and radical adrenalectomy for tumors >6 cm or adrenal carcinoma. Most prostatectomies can be delayed without compromising the survival rate of patients. Urological emergencies should be treated adequately even during this pandemic. There is a potential risk of coronavirus diffusion during minimally invasive procedures performed. It is crucial to use specific precautions when urologists performed those type of surgeries. It was also recommended to suspend the kidney transplantation program during the COVID-19 pandemic except for specific cases. In this review, we discussed the triage of urological surgeries, the risk of minimally invasive urological procedure, the kidney transplantation challenges, the systemic therapies, intravesical instillation of Bacillus Calmette-Guérin (BCG), endourology, teleconferencing, and telemedicine application in urology during the COVID-19 pandemic.

Effects of intravesical BCG maintenance therapy duration on recurrence rate in high-risk non-muscle invasive bladder cancer (NMIBC): Systematic review and network meta-analysis according to EAU COVID-19 recommendations

“…Although the optimal duration of maintenance therapy for patients with high-risk NMIBC remains controversial, EAU’s guidelines recommend 3-week instillations at 3, 6, 12, 18, 24, 30, and 36 months. As the COVID-19 pandemic has had a serious impact on urological treatments [ 9 ], Lenfant et al reported that intravesical BCG therapy could be discontinued safely for patients with high-risk NMIBC [ 8 ]. Furthermore, according to EAU’s NMIBC panel during the pandemic, a 1-year BCG maintenance immunotherapy in patients with high-risk NMIBC was recommended [ 10 ].…”

“…The coronavirus disease 2019, also known as COVID-19, has spread around the world, and the World Health Organization officially declared it a pandemic on March 11, 2020. Healthcare has been severely impacted, and urology practices have also been affected by the COVID-19 pandemic [ 9 ]. According to EAU’s COVID-19 recommendations, EAU’s NMIBC panel recommends 1-year intravesical BCG maintenance immunotherapy in patients with high-risk NMIBC [ 10 ].…”

Consequences of SARS-CoV-2 pandemic on urological surgery in France: a nationwide analysis of the healthcare system database

“…On the contrary for patients with intermediate risk or poor-risk prognosis of metastatic kidney cancer, surgical therapy can often be deferred in favour of effective systemic therapy, which does not require hospital admissions 20. However, in any oncological disease, the diagnosis and timely treatment should not be compromised 19 22…”

Urosepsis During Covid-19 Pandemic

“…The current COVID-19 pandemic underlines the importance of changing some aspects of urology practice, from patient consultation to the triage of urologic surgeries. The pandemic of COVID-19 has serious implications on urology practice and raises particular questions for urologists about the management of different conditions [36].…”