Links to Exploration step
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Urolithiasis Practice Patterns Following the COVID-19 Pandemic: Overview from the EULIS Collaborative Research Working Group</title><author><name sortKey="Tefik, Tzevat" sort="Tefik, Tzevat" uniqKey="Tefik T" first="Tzevat" last="Tefik">Tzevat Tefik</name><affiliation><nlm:aff id="aff0005">Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Guven, Selcuk" sort="Guven, Selcuk" uniqKey="Guven S" first="Selcuk" last="Guven">Selcuk Guven</name><affiliation><nlm:aff id="aff0010">Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Villa, Luca" sort="Villa, Luca" uniqKey="Villa L" first="Luca" last="Villa">Luca Villa</name><affiliation><nlm:aff id="aff0015">Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Gokce, Mehmet Ilker" sort="Gokce, Mehmet Ilker" uniqKey="Gokce M" first="Mehmet Ilker" last="Gokce">Mehmet Ilker Gokce</name><affiliation><nlm:aff id="aff0020">Department of Urology, School of Medicine, Ankara University, Ankara, Turkey</nlm:aff></affiliation></author><author><name sortKey="Kallidonis, Panagiotis" sort="Kallidonis, Panagiotis" uniqKey="Kallidonis P" first="Panagiotis" last="Kallidonis">Panagiotis Kallidonis</name><affiliation><nlm:aff id="aff0025">Department of Urology, University Hospital of Patras, Patras, Greece</nlm:aff></affiliation></author><author><name sortKey="Petkova, Kremena" sort="Petkova, Kremena" uniqKey="Petkova K" first="Kremena" last="Petkova">Kremena Petkova</name><affiliation><nlm:aff id="aff0030">Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria</nlm:aff></affiliation></author><author><name sortKey="Kiremit, Murat Can" sort="Kiremit, Murat Can" uniqKey="Kiremit M" first="Murat Can" last="Kiremit">Murat Can Kiremit</name><affiliation><nlm:aff id="aff0035">Department of Urology, School of Medicine, Koç University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sonmez, Mehmet Giray" sort="Sonmez, Mehmet Giray" uniqKey="Sonmez M" first="Mehmet Giray" last="Sonmez">Mehmet Giray Sonmez</name><affiliation><nlm:aff id="aff0040">Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey</nlm:aff></affiliation></author><author><name sortKey="De Lorenzis, Elisa" sort="De Lorenzis, Elisa" uniqKey="De Lorenzis E" first="Elisa" last="De Lorenzis">Elisa De Lorenzis</name><affiliation><nlm:aff id="aff0045">Department of Urology, Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Eryildirim, Bilal" sort="Eryildirim, Bilal" uniqKey="Eryildirim B" first="Bilal" last="Eryildirim">Bilal Eryildirim</name><affiliation><nlm:aff id="aff0050">Department of Urology, Health Sciences University, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sarica, Kemal" sort="Sarica, Kemal" uniqKey="Sarica K" first="Kemal" last="Sarica">Kemal Sarica</name><affiliation><nlm:aff id="aff0055">Department of Urology, Medical School, Biruni University, Medicana Bahcelievler Hospital, Istanbul, Turkey</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmc">7183952</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183952</idno><idno type="RBID">PMC:7183952</idno><idno type="doi">10.1016/j.eururo.2020.04.057</idno><idno type="pmid">NONE</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000464</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000464</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Urolithiasis Practice Patterns Following the COVID-19 Pandemic: Overview from the EULIS Collaborative Research Working Group</title><author><name sortKey="Tefik, Tzevat" sort="Tefik, Tzevat" uniqKey="Tefik T" first="Tzevat" last="Tefik">Tzevat Tefik</name><affiliation><nlm:aff id="aff0005">Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Guven, Selcuk" sort="Guven, Selcuk" uniqKey="Guven S" first="Selcuk" last="Guven">Selcuk Guven</name><affiliation><nlm:aff id="aff0010">Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Villa, Luca" sort="Villa, Luca" uniqKey="Villa L" first="Luca" last="Villa">Luca Villa</name><affiliation><nlm:aff id="aff0015">Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Gokce, Mehmet Ilker" sort="Gokce, Mehmet Ilker" uniqKey="Gokce M" first="Mehmet Ilker" last="Gokce">Mehmet Ilker Gokce</name><affiliation><nlm:aff id="aff0020">Department of Urology, School of Medicine, Ankara University, Ankara, Turkey</nlm:aff></affiliation></author><author><name sortKey="Kallidonis, Panagiotis" sort="Kallidonis, Panagiotis" uniqKey="Kallidonis P" first="Panagiotis" last="Kallidonis">Panagiotis Kallidonis</name><affiliation><nlm:aff id="aff0025">Department of Urology, University Hospital of Patras, Patras, Greece</nlm:aff></affiliation></author><author><name sortKey="Petkova, Kremena" sort="Petkova, Kremena" uniqKey="Petkova K" first="Kremena" last="Petkova">Kremena Petkova</name><affiliation><nlm:aff id="aff0030">Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria</nlm:aff></affiliation></author><author><name sortKey="Kiremit, Murat Can" sort="Kiremit, Murat Can" uniqKey="Kiremit M" first="Murat Can" last="Kiremit">Murat Can Kiremit</name><affiliation><nlm:aff id="aff0035">Department of Urology, School of Medicine, Koç University, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sonmez, Mehmet Giray" sort="Sonmez, Mehmet Giray" uniqKey="Sonmez M" first="Mehmet Giray" last="Sonmez">Mehmet Giray Sonmez</name><affiliation><nlm:aff id="aff0040">Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey</nlm:aff></affiliation></author><author><name sortKey="De Lorenzis, Elisa" sort="De Lorenzis, Elisa" uniqKey="De Lorenzis E" first="Elisa" last="De Lorenzis">Elisa De Lorenzis</name><affiliation><nlm:aff id="aff0045">Department of Urology, Ospedale Maggiore Policlinico, Milan, Italy</nlm:aff></affiliation></author><author><name sortKey="Eryildirim, Bilal" sort="Eryildirim, Bilal" uniqKey="Eryildirim B" first="Bilal" last="Eryildirim">Bilal Eryildirim</name><affiliation><nlm:aff id="aff0050">Department of Urology, Health Sciences University, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey</nlm:aff></affiliation></author><author><name sortKey="Sarica, Kemal" sort="Sarica, Kemal" uniqKey="Sarica K" first="Kemal" last="Sarica">Kemal Sarica</name><affiliation><nlm:aff id="aff0055">Department of Urology, Medical School, Biruni University, Medicana Bahcelievler Hospital, Istanbul, Turkey</nlm:aff></affiliation></author></analytic><series><title level="j">European Urology</title><idno type="ISSN">0302-2838</idno><idno type="eISSN">1873-7560</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Wang, D" uniqKey="Wang D">D. Wang</name></author><author><name sortKey="Hu, B" uniqKey="Hu B">B. Hu</name></author><author><name sortKey="Hu, C" uniqKey="Hu C">C. Hu</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Zeng, G" uniqKey="Zeng G">G. Zeng</name></author><author><name sortKey="Zhao, Z" uniqKey="Zhao Z">Z. Zhao</name></author><author><name sortKey="Yang, F" uniqKey="Yang F">F. Yang</name></author><author><name sortKey="Zhong, W" uniqKey="Zhong W">W. Zhong</name></author><author><name sortKey="Wu, W" uniqKey="Wu W">W. Wu</name></author><author><name sortKey="Chen, W" uniqKey="Chen W">W. Chen</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="letter"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Eur Urol</journal-id><journal-id journal-id-type="iso-abbrev">Eur. Urol</journal-id><journal-title-group><journal-title>European Urology</journal-title></journal-title-group><issn pub-type="ppub">0302-2838</issn><issn pub-type="epub">1873-7560</issn><publisher><publisher-name>Published by Elsevier B.V. on behalf of European Association of Urology.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmc">7183952</article-id><article-id pub-id-type="publisher-id">S0302-2838(20)30325-0</article-id><article-id pub-id-type="doi">10.1016/j.eururo.2020.04.057</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Urolithiasis Practice Patterns Following the COVID-19 Pandemic: Overview from the EULIS Collaborative Research Working Group</article-title></title-group><contrib-group><contrib contrib-type="author" id="aut0005"><name><surname>Tefik</surname><given-names>Tzevat</given-names></name><xref rid="aff0005" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="aut0010"><name><surname>Guven</surname><given-names>Selcuk</given-names></name><email>selcukguven@hotmail.com</email><xref rid="aff0010" ref-type="aff">b</xref><xref rid="cor0005" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="aut0015"><name><surname>Villa</surname><given-names>Luca</given-names></name><xref rid="aff0015" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="aut0020"><name><surname>Gokce</surname><given-names>Mehmet Ilker</given-names></name><xref rid="aff0020" ref-type="aff">d</xref></contrib><contrib contrib-type="author" id="aut0025"><name><surname>Kallidonis</surname><given-names>Panagiotis</given-names></name><xref rid="aff0025" ref-type="aff">e</xref></contrib><contrib contrib-type="author" id="aut0030"><name><surname>Petkova</surname><given-names>Kremena</given-names></name><xref rid="aff0030" ref-type="aff">f</xref></contrib><contrib contrib-type="author" id="aut0035"><name><surname>Kiremit</surname><given-names>Murat Can</given-names></name><xref rid="aff0035" ref-type="aff">g</xref></contrib><contrib contrib-type="author" id="aut0040"><name><surname>Sonmez</surname><given-names>Mehmet Giray</given-names></name><xref rid="aff0040" ref-type="aff">h</xref></contrib><contrib contrib-type="author" id="aut0045"><name><surname>de Lorenzis</surname><given-names>Elisa</given-names></name><xref rid="aff0045" ref-type="aff">i</xref></contrib><contrib contrib-type="author" id="aut0050"><name><surname>Eryildirim</surname><given-names>Bilal</given-names></name><xref rid="aff0050" ref-type="aff">j</xref></contrib><contrib contrib-type="author" id="aut0055"><name><surname>Sarica</surname><given-names>Kemal</given-names></name><xref rid="aff0055" ref-type="aff">k</xref></contrib><aff id="aff0005"><label>a</label>Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey</aff><aff id="aff0010"><label>b</label>Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey</aff><aff id="aff0015"><label>c</label>Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy</aff><aff id="aff0020"><label>d</label>Department of Urology, School of Medicine, Ankara University, Ankara, Turkey</aff><aff id="aff0025"><label>e</label>Department of Urology, University Hospital of Patras, Patras, Greece</aff><aff id="aff0030"><label>f</label>Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria</aff><aff id="aff0035"><label>g</label>Department of Urology, School of Medicine, Koç University, Istanbul, Turkey</aff><aff id="aff0040"><label>h</label>Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey</aff><aff id="aff0045"><label>i</label>Department of Urology, Ospedale Maggiore Policlinico, Milan, Italy</aff><aff id="aff0050"><label>j</label>Department of Urology, Health Sciences University, Dr. Lütfi Kirdar Training and Research Hospital, Istanbul, Turkey</aff><aff id="aff0055"><label>k</label>Department of Urology, Medical School, Biruni University, Medicana Bahcelievler Hospital, Istanbul, Turkey</aff></contrib-group><author-notes><corresp id="cor0005"><label>⁎</label>Corresponding author. Department of Urology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey. <email>selcukguven@hotmail.com</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>27</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>27</day><month>4</month><year>2020</year></pub-date><history><date date-type="accepted"><day>21</day><month>4</month><year>2020</year></date></history><permissions><copyright-statement>© 2020 Published by Elsevier B.V. on behalf of European Association of Urology.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions></article-meta></front><body><p id="par0005">COVID-19 was first reported as a novel pulmonary infection in December 2019 <xref rid="bib0005" ref-type="bibr">[1]</xref>. Apart from being a potentially lethal condition, COVID-19 is also affecting health care strategies for other medical conditions. Ficarra et al <xref rid="bib0010" ref-type="bibr">[2]</xref> have made suggestions regarding urological surgeries during the COVID-19 pandemic. However, the authors focused on all urological pathologies and reported information from Italy, a country that seemed to be the epicenter of the pandemic in Europe <xref rid="bib0010" ref-type="bibr">[2]</xref>. Therefore, we sought to obtain an up-to-date perspective on how the routine practice patterns of expert European endourologists changed (or adapted) during the COVID-19 pandemic via a survey. By focusing on expert experience coming from the field, we aimed to provide an algorithm to guide the management of urinary stone disease during this unprecedented time of extraordinary stress on the global endourology community.</p><p id="par0010">An online survey composed of 31 questions (Supplementary material) using the web-based Survey-Monkey system (Palo Alto, CA) was circulated primarily to authors who were in the EULIS working groups, whose main areas of expertise was urinary stone disease, and who had contributed to the literature to date. Among 98 experts approached, 60 physicians (61.2%) responded.</p><p id="par0015">The distribution of the countries involved is given in <xref rid="tbl0005" ref-type="table">Table 1</xref>. At the time of survey completion, the first COVID-19 pandemic case was reported >21 d previously in the country of 67.2% of the respondents and between 7 and 21 d previously in the country of 32.8% of the respondents (<xref rid="tbl0005" ref-type="table">Table 1</xref>). While all responding experts experienced a change of at least 25% in routine clinical practice, 49% reported a change of >90% in (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>A). Among the experts, 72.3% used telemedicine during the pandemic (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>B).<table-wrap position="float" id="tbl0005"><label>Table 1</label><caption><p>Data for the 60 participants from 20 different countries interested in urolithiasis who were included in the study survey.<xref rid="tblfn0005" ref-type="table-fn">a</xref></p></caption><alt-text id="at0015">Table 1</alt-text><table frame="hsides" rules="groups"><thead><tr><th align="left">Country</th><th align="center">Region(s)</th><th align="center">Total cases</th><th align="center">Time between officially reported first case and response to the survey (d)</th><th align="center">Total deaths due to COVID-19</th><th align="center">Time between officially reported first 10 deaths and response to the survey (d)</th></tr></thead><tbody><tr><td align="left">Azerbaijan</td><td align="left">Baku</td><td align="left">298</td><td align="left">31</td><td align="left">5</td><td align="left">Not applicable</td></tr><tr><td align="left">Austria</td><td align="left">Vienna, Salzburg</td><td align="left">10 182</td><td align="left">35</td><td align="left">128</td><td align="left">9</td></tr><tr><td align="left">Belgium</td><td align="left">Gent</td><td align="left">12 775</td><td align="left">56</td><td align="left">705</td><td align="left">15</td></tr><tr><td align="left">Bulgaria</td><td align="left">Sofia</td><td align="left">399</td><td align="left">24</td><td align="left">8</td><td align="left">Not applicable</td></tr><tr><td align="left">Czechia</td><td align="left">South Bohemia</td><td align="left">3308</td><td align="left">30</td><td align="left">31</td><td align="left">3</td></tr><tr><td align="left">Denmark</td><td align="left">Fredericia, Copenhagen</td><td align="left">2860</td><td align="left">34</td><td align="left">90</td><td align="left">10</td></tr><tr><td align="left">France</td><td align="left">Paris</td><td align="left">51 477</td><td align="left">69</td><td align="left">3523</td><td align="left">24</td></tr><tr><td align="left">Georgia</td><td align="left">Tbilisi</td><td align="left">115</td><td align="left">34</td><td align="left">0</td><td align="left">Not applicable</td></tr><tr><td align="left">Germany</td><td align="left">Baden-Württemberg, Bavaria, Niedersachsen</td><td align="left">67 366</td><td align="left">66</td><td align="left">775</td><td align="left">16</td></tr><tr><td align="left">Greece</td><td align="left">Patras, Northeastern Greece</td><td align="left">1314</td><td align="left">34</td><td align="left">49</td><td align="left">11</td></tr><tr><td align="left">Italy</td><td align="left">Bergamo, Lombardy, Rome, Milan, Naples</td><td align="left">105 792</td><td align="left">63</td><td align="left">12428</td><td align="left">35</td></tr><tr><td align="left">North Macedonia</td><td align="left">Skopje</td><td align="left">329</td><td align="left">34</td><td align="left">9</td><td align="left">Not applicable</td></tr><tr><td align="left">Poland</td><td align="left">Malopolska</td><td align="left">2311</td><td align="left">28</td><td align="left">33</td><td align="left">7</td></tr><tr><td align="left">Romania</td><td align="left">Bucharest</td><td align="left">2245</td><td align="left">33</td><td align="left">69</td><td align="left">7</td></tr><tr><td align="left">Russia</td><td align="left">Saint Petersburg</td><td align="left">2337</td><td align="left">60</td><td align="left">17</td><td align="left">0</td></tr><tr><td align="left">Serbia</td><td align="left">Belgrade</td><td align="left">900</td><td align="left">25</td><td align="left">13</td><td align="left">2</td></tr><tr><td align="left">Spain</td><td align="left">Barcelona, Valladolid, Catalonia, Comunidad Valenciana, Madrid, Alicante, Granada</td><td align="left">94 417</td><td align="left">62</td><td align="left">8464</td><td align="left">24</td></tr><tr><td align="left">Sweden</td><td align="left">Stockholm</td><td align="left">4435</td><td align="left">61</td><td align="left">180</td><td align="left">13</td></tr><tr><td align="left">Turkey</td><td align="left">Ankara, Istanbul, Konya</td><td align="left">13 531</td><td align="left">20</td><td align="left">214</td><td align="left">10</td></tr><tr><td align="left">UK</td><td align="left">London, Manchester, Cambridgeshire</td><td align="left">25 150</td><td align="left">62</td><td align="left">1789</td><td align="left">20</td></tr></tbody></table><table-wrap-foot><fn id="tblfn0005"><label>a</label><p id="npar0005">Data in the table were collected from the websites <ext-link ext-link-type="uri" xlink:href="http://www.who.int/emergencies/diseases/novel-coronavirus-2019" id="intr0005">www.who.int/emergencies/diseases/novel-coronavirus-2019</ext-link>, <ext-link ext-link-type="uri" xlink:href="http://www.worldometers.info/coronavirus" id="intr0010">www.worldometers.info/coronavirus</ext-link>, and <ext-link ext-link-type="uri" xlink:href="https://ourworldindata.org/coronavirus" id="intr0015">https://ourworldindata.org/coronavirus</ext-link> using information updated on March 31, 2020.</p></fn></table-wrap-foot></table-wrap><fig id="fig0005"><label>Fig. 1</label><caption><p>Practice patterns among expert endourologists during the COVID-19 pandemic.</p></caption><alt-text id="at0005">Fig. 1</alt-text><graphic xlink:href="gr1_lrg"></graphic></fig></p><p id="par0020">The majority of the experts (89.4%) tended to change their treatment strategy for an emergency patient with COVID-19 by planning an elective intervention following drainage of the collecting system; however, 10.6% continued to perform stone removal procedures in these cases. Some 43% of respondents continued to use a surgical mask as before the pandemic, whereas 17% did not perform surgery. Regarding eye protection, 25.5% started using goggles, 21.3% were already using goggles, and 34% did not shift to the use of goggles as part of their pandemic response.</p><p id="par0025">Among the respondents, 55.3% and 39.8% changed their elective surgical treatment approach after COVID-19 by a rate of 90–100% and 75–89%, respectively. Only 6.4% continued as before the pandemic. From an anesthesiology point of view, routine thorax computed tomography (CT) was requested 24 h before surgery by 27.7% of the experts, whereas, 61.7% requested thorax CT in the case of COVID-19 suspicion. Some 34% of the respondents preferred spinal anesthesia instead of general anesthesia, whereas 17% continued with spinal anesthesia as used before the pandemic (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>C), possibly because of the well-known safety of spinal anesthesia in stone surgery <xref rid="bib0015" ref-type="bibr">[3]</xref>. Unless contraindicated, we think that endourologists may prefer regional anesthesia during the COVID-19 pandemic, depending on their hospital conditions.</p><p id="par0030">Nearly half of the respondents (48.9%) stated that COVID-19 patients have been hospitalized in their departments, with approximately 40% taking an active role in evaluating respiratory symptoms in these patients (<xref rid="fig0005" ref-type="fig">Fig. 1</xref>D). Therefore, it is obvious that although not specializing in the management of contagious diseases, all health care staff including doctors specializing in other disciplines have been obliged to deal with the pandemic. More than 85% of the participants reported a decrease of >50% in the workload of outpatient clinics. Routine treatment protocols for stone management were reported as altered by 91.3% of the experts. Changes in routine treatment protocols were further investigated in the questionnaire for certain clinical situations. For management of stones of <2 cm and 2–3 cm in size, 31.9% and 27.6% of the participants, respectively, stated that they would prefer a conservative approach until the pandemic settles. In addition, approximately two-thirds stated that they would postpone any auxiliary procedure because of the COVID-19 pandemic and 51% stated that they would discharge patients on the same day or within 24 h postoperatively.</p><p id="par0035">Another important aspect is emergency department admission of stone patients. Emergency physicians encounter stone patients with more severe conditions such as colic pain, acute renal failure, and pyelonephritis. The survey outlined that emergency department management of stone patients was also altered in more than 90% of cases during this period. Although the approach to stone patients in the emergency department was the same as before according to 6.4% of the experts, 55.3% began to accept cases from another COVID-19 area at the same emergency department, 25.5% accepted emergent urolithiasis cases in a newly organized space in the hospital, and 10.6% did not accept COVID-19 cases at all. Some 2% of the respondents referred emergent urolithiasis cases to other specialized COVID-19 centers. While timely management of these cases in the emergency department is crucial, clinical controversies arise if these patients are also suspicious for COVID-19. A possible scenario of a patient presenting to the emergency department with severe colic pain, fever, and cough would be a real dilemma for physicians. In the survey, nearly 90% of the participants stated that they would change the treatment strategy for an emergency case when the patient is positive for COVID-19. Therefore, clinical algorithms for cases presenting with renal obstruction, urinary tract infection, and acute renal failure would be helpful (<xref rid="fig0010" ref-type="fig">Fig. 2</xref>). Changes in sterilization strategies during the COVID-19 pandemic were also included in the questionnaire: only 34.8% of the respondents did change their routine strategy for sterilization. This may be because of either a lack of knowledge on the risk of urine-based dissemination of viral RNA or a lack of modification of sterilization strategies in hospitals in the short time immediately after the first case report on COVID-19.<fig id="fig0010"><label>Fig. 2</label><caption><p>Treatment algorithm for urinary stone patients during the COVID-19 pandemic. UTI = urinary tract infection; qSOFA = quick sepsis-related organ failure assessment.</p></caption><alt-text id="at0010">Fig. 2</alt-text><graphic xlink:href="gr2_lrg"></graphic></fig></p><p id="par0040">In many European countries, the pandemic started more than 3 wk ago and has gained momentum, and our survey was carried out during this critical period. When faced with such an unexpected situation, urologists, like other physicians, tend to use all of the resources available in their web-based environment, such as European Association of Urology COVID-19 resources for urologists, the American Urological Association coronavirus disease 2019 information center, and social media. The COVID-19 pandemic has led to significant changes in the practice patterns of endourologists for the management of urinary stone disease. Given the risk of novel viral pandemics in the future, the endourology community should be aware of possible alterations in clinical practice. Clinical algorithms may serve as a useful guide in adapting to these changes in time and in managing patients with urinary calculi safely and successfully.</p><p id="par0045">
<bold><italic>Conflicts of interest:</italic></bold> The authors have nothing to disclose.</p></body><back><ref-list id="bibl0005"><title>References</title><ref id="bib0005"><label>1</label><element-citation publication-type="journal" id="sbref0005"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>D.</given-names></name><name><surname>Hu</surname><given-names>B.</given-names></name><name><surname>Hu</surname><given-names>C.</given-names></name></person-group><article-title>Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China</article-title><source>JAMA</source><volume>323</volume><year>2020</year><fpage>1061</fpage><lpage>1069</lpage></element-citation></ref><ref id="bib0010"><label>2</label><mixed-citation publication-type="other" id="oref0005">Ficarra V, Novara G, Abrate A, et al. Urology practice during COVID-19 pandemic. Minerva Urol Nefrol. In press. <pub-id pub-id-type="doi">10.23736/S0393-2249.20.03846-1</pub-id>.</mixed-citation></ref><ref id="bib0015"><label>3</label><element-citation publication-type="journal" id="sbref0010"><person-group person-group-type="author"><name><surname>Zeng</surname><given-names>G.</given-names></name><name><surname>Zhao</surname><given-names>Z.</given-names></name><name><surname>Yang</surname><given-names>F.</given-names></name><name><surname>Zhong</surname><given-names>W.</given-names></name><name><surname>Wu</surname><given-names>W.</given-names></name><name><surname>Chen</surname><given-names>W.</given-names></name></person-group><article-title>Retrograde intrarenal surgery with combined spinal-epidural vs general anesthesia: a prospective randomized controlled trial</article-title><source>J Endourol</source><volume>29</volume><year>2015</year><fpage>401</fpage><lpage>405</lpage><pub-id pub-id-type="pmid">25358059</pub-id></element-citation></ref></ref-list><sec id="sec0010" sec-type="supplementary-material"><label>Appendix A</label><title>Supplementary data</title><p id="par0055">The following is Supplementary data to this article:<supplementary-material content-type="local-data" id="upi0005"><media xlink:href="mmc1.docx"></media></supplementary-material></p></sec><fn-group><fn id="sec0005" fn-type="supplementary-material"><label>Appendix A</label><p id="par0050">Supplementary material related to this article can be found, in the online version, at doi:<ext-link ext-link-type="uri" xlink:href="https://doi.org/10.1016/j.eururo.2020.04.057" id="intr0020">https://doi.org/10.1016/j.eururo.2020.04.057</ext-link>.</p></fn></fn-group></back></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/StressCovidV1/Data/Pmc/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000464 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Corpus/biblio.hfd -nk 000464 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= StressCovidV1
|flux= Pmc
|étape= Corpus
|type= RBID
|clé=
|texte=
}}
| This area was generated with Dilib version V0.6.33. |  |