The COVID-19 pandemic has dramatically affected the Female and Functional Urology (FFU) practice, leading to massive waiting lists, while patients' quality of life remains severely impaired. The aim of the present study is to develop consensual recommendations to guide clinicians on the management of FFU patients. The present paper focusses on female LUTS.
The authors used the Delphi methodology to develop a robust survey questionnaire, covering the principal topics in FFU, based on literature review and expert opinions. Regarding female LUTS, a 98-question survey was distributed among FFU specialists to obtain optimized recommendations, under the auspicious of the International Continence Society (TURNOVER, ICS project). A quantitative analysis of the data was performed, categorizing the mean value from 0-10. Consensus achievement was defined as attaining ≥ 70% agreement.
98 ICS members completed the F-LUTS survey. Recommendations for the diagnosis and management of female LUTS are summarized. Video-consultation should be used for initial assessment, sending questionnaires and bladder diaries in advance to the patient to be filled out before the consultation. However, face-to-face visits are mandatory if POP or continuous incontinence are suspected, and prior to any surgical procedure, regardless of the health alert. Moreover, prescribing medications such as anticholinergics or β 3 agonists in a telemedicine setting is not considered a safe practice. Follow-up teleconsultations can be used to assess the efficacy and treatment-related adverse events.Urodynamic testing should be only performed if consequences on F-LUTS treatment are expected. The study should be postponed until the pandemic local behaviour flattens.Invasive procedures should be postponed during a high alert. In case surgery is scheduled, outpatient clinics and local anaesthesia should be prioritised. Every patient should be screened for SARS-CoV-2 infection before invasive tests or procedures, following local authorities'guidance.
During a pandemic, telemedicine offers a novel way of communication, maintaining medical care while preventing viral transmission. Non-urgent procedures should be postponed until the pandemic curve flattens. Ambulatory procedures under regional or local anaesthesia should be prioritised, aiming to reduce bed occupancy and risk of transmission.
Continence (Amsterdam, Netherlands). 2022 Nov 17 [Epub ahead of print]
Luis López-Fando, Paola Calleja Hermosa, Sakineh Hajebrahimi, Mauricio Plata, Bárbara Padilla Fernández, Francisco Cruz, Hashim Hashim, Salvador Arlandis
Department of Urology, Functional Urology section, Hospital La Princesa, Madrid, Spain., Department of Urology, University Hospital Marqués de Valdecilla, Santander, Spain., Research Center for Evidence-Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute (JBI) Center of Excellence, Tabriz University of Medical, Tabriz, Iran., Hospital Universitario de la Fundación Santa Fe de Bogotá, University of Los Andes, School of medicine, Colombia., Department of Urology, Canarias University Hospital, Tenerife, Spain., Department of Urology, Hospital São João, Porto, Portugal., Bristol Urological Institute, Southmead Hospital, Bristol, UK., Department of Urology, La Fe University and Polytechnic Hospital, Valencia, Spain.