Impact of COVID-19 on management of urogynaecology patients: a rapid review of the literature

Introduction and hypothesis The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly...

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Bibliographic Details
Published in:International Urogynecology Journal 2021-10, Vol.32 (10), p.2631-2646
Main Authors: Loganathan, Jemina, Doumouchtsis, Stergios K.
Format: Article
Language:English
Subjects:
Coronaviruses
COVID-19
Disease transmission
Gynecology
Humans
Medicine
Medicine & Public Health
Pandemics
Review
Review Article
SARS-CoV-2
Telemedicine
Urologic Surgical Procedures
Urology
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Summary:Introduction and hypothesis The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly available, and this rapid review aimed to provide a timely evidence synthesis on the current recommendations surrounding urogynaecological care. Methods We performed a literature review using PubMed/Medline, Embase and Cochrane and a manual search of national and international societies for management recommendations for urogynaecological patients during the COVID-19 pandemic. Results Nine guidance documents and 17 articles, including 10 reviews, were included. Virtual clinics are recommended for new and follow-up patients, to assess and initiate treatment, as well as triage patients who require face-to-face appointments. Outpatient investigations such as urodynamics and cystoscopy for benign indications can be deferred. Prolapse and continence surgery should be suspended, except in specific circumstances such as procidentia with upper tract complications and failed pessaries. There is no evidence to support a particular route of surgery, but recommendations are made to minimise COVID-19 transmission. Conclusions Urogynaecological patients face particular challenges owing to inherent vulnerabilities of these populations. Behavioural and medical therapies should be recommended as first line options and initiated via virtual or remote clinics, which are integral to management during the COVID-19 pandemic. Expanding the availability and accessibility of technology will be increasingly required. The majority of outpatient and inpatient procedures can be deferred, but the longer-term effects of such practices are unclear.
ISSN:0937-3462
1433-3023
DOI:10.1007/s00192-021-04704-2