Author(s): Philippine Urological Association, Inc.
These are unprecedented times. This is why we do not have a ready-made playbook to tackle the pandemic and how to modify our current practice to accommodate the situation appropriately. Nevertheless, our goals are in consonance with the national government, Department of Health and the country as a whole, these are: to stop the transmission of the COVID-19 virus, to protect our medical staff, to maximize the use of resources necessary to treat COVID-19 patients and to minimize collateral damage to patients requiring care for non-COVID diseases.
There is limited literature available on the topic of Urology practice in times of pandemic. The situation is evolving at a different pace in different parts of the world. We are fortunate that the American Urological Association, European Association of Urologists through ERUS (European Robotic Urology Section) and Italy through (Research Urology Network) have published their guidelines to aid their members in modifying their practice to address the present situation. These guidelines are applicable to our local situation since we are faced with the same set of challenges: an increasing number of COVID positive patients, the possibility of our healthcare system being overwhelmed by COVID positive patients with moderate to severe symptoms, the limited number of personal protective equipment or PPE to ensure the safety of our medical staff, and the limited number of ICU beds and ventilators.
From the above sources, we are adopting the following guidelines, all of which are aimed at providing recommendations to the urologic community based on the available evidences. Urologists are invited to apply the following recommendations in their hospitals when performing procedures on patients.
1. General Protection
2. Patient Selection
3. Urgent Procedures
4. Procedures for Cancer Cases
5. Procedures for Benign Diseases
6. All diagnostic procedures aimed at evaluating benign conditions
7. Management of COVID-19 Positive Patients
8. Surgical Approach, Techniques and New Technologies
9. Prevention and Management of Aerosol Dispersal in Laparoscopic Surgery
10. Surgical Smoke
11. Pneumoperitoneum Disinflation
12. Renal Transplantation
13. Operating staff protection
Key words: Urology Practice During the COVID-19