Where do Urologists Stand in the Era of Novel Coronavirus-2019 Disease

Thomas Hughes; Hui Ching Ho; Shahrokh F. Shariat; Bhaskar Kumar Somani

Curr Opin Urol. 2020;30(4):610-616.

Conclusion

Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of need. Face-to-face contact is largely minimized and innovative, virtual communication methods are used in the outpatient setting and multidisciplinary team meetings. Surgical practice is changing because of the risks posed by COVID-19 and procedures can be prioritized in a nonurgent, low priority, high priority or emergency category. Although the COVID-19 pandemic will inevitably affect urological services, steps can be taken to mitigate the impact and prioritize the patients most in need of urgent care.

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Table 1. Showing prioritization for nononcological disease
	Nonurgent	Low priority	High priority	Emergency
Renal stone disease	Asymptomatic renal stone		Obstructing ureteric stone Stone disease with ureteric stent in situ	Obstructed/infected kidney
Renal transplant	Live donor renal transplantation		Deceased donor renal transplantation
Benign scrotal	Hydrocele/varicocele			Testicular torsion
Infection				Scrotal abscess/Fourniers gangrene
Haematuria		Flexible cystoscopy		Clot retention
Other	Andrology and incontinence surgery			Urinary tract trauma surgery

Table 2. Showing prioritization for oncological disease
	Low priority	High priority
Renal cancer	Nephrectomy (low risk)	Nephrectomy (high risk)
Upper urinary tract cancer	Nephroureterectomy (low risk)	Nephroureterectomy (high risk)
Bladder cancer	Cystectomy (low risk) TURBT (low risk)	Cystectomy (high risk) TURBT (high risk)
Prostate cancer	Radical prostatectomy transrectal/perineal prostate biopsy
Testicular cancer		Orchidectomy