To understand how the lack of a physical examination during new patient video visits can impact urological surgery planning during the COVID-19 pandemic.
We retrospectively reviewed 590 consecutive urology patients who underwent new patient video visits from March through May 2020 at a single academic center. Our primary outcome was procedural plan concordance, the proportion of video visit surgical plans that remained the same after the patient was seen in-person, either in clinic or on day of surgery. Median days between video and in-person visits were compared between concordant and discordant cases using the Mann-Whitney U test; P < .05 was significant.
Overall, 195 (33%) were evaluated by new patient video visits and had a procedure scheduled, of which, 186 (95%) had concordant plans after in-person evaluation. Further, 99% of plans for in-office procedures and 91% for operating room procedures were unchanged. Four patients (2.1%) had surgical plans altered after changes in clinical course, two (1%) due to additional imaging, and three (1.5%) based on genitourinary examination findings. Days between video visit and in-person evaluation did not differ significantly in concordant cases (median 37.5 [IQR, 16 - 80.5]) as compared to discordant cases (median 58.0 [IQR, 20 - 224]; P = .12).
Most surgical plans developed during new patient video visits remain unchanged after in-person examination. However, changes in clinical course or updated imaging can alter operative plans. Likewise, certain urologic conditions (eg, penile cancer) rely on the genitourinary examination to dictate surgical approach.
Urology. 2022 Jun 28 [Epub ahead of print]
Nicholas W Eyrich, Juan J Andino, Roberta E Ukavwe, Mark W Farha, Akshar K Patel, Daniel Triner, Chad Ellimoottil
Department of Urology, Emory University School of Medicine, Atlanta, GA; Department of Urology, Michigan Medicine, Ann Arbor, MI. Electronic address: ., Department of Urology, Michigan Medicine, Ann Arbor, MI., Department of Anesthesiology, Michigan Medicine, Ann Arbor, MI., Department of Urology, Michigan Medicine, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, Ann Arbor, MI.