Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, Italy.
Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy.
Eur Urol. 2020 Dec;78(6):786-811. doi: 10.1016/j.eururo.2020.06.025. Epub 2020 Jun 18.
Coronavirus disease 2019 (COVID-19) pandemic has caused increased interest in the application of telehealth to provide care without exposing patients and physicians to the risk of contagion. The urological literature on the topic is sparse.
To perform a systematic review of the literature and evaluate all the available studies on urological applications of telehealth.
After registration on PROSPERO, we searched PubMed and Scopus databases to collect any kind of studies evaluating any telehealth interventions in any urological conditions. The National Toxicology Program/Office of Health Assessment and Translation Risk of Bias Rating Tool for Human and Animal Studies was used to estimate the risk of bias. A narrative synthesis was performed.
We identified 45 studies (11 concerning prostate cancer [PCa], three hematuria management, six urinary stones, 14 urinary incontinence [UI], five urinary tract infections [UTIs], and six other conditions), including 12 randomized controlled trials. The available literature indicates that telemedicine has been implemented successfully in several common clinical scenarios, including the decision-making process following a diagnosis of nonmetastatic PCa, follow-up care of patients with localized PCa after curative treatments, initial diagnosis of hematuria, management diagnosis and follow-up care of uncomplicated urinary stones and uncomplicated UTIs, and initial evaluation, behavioral therapies, and pelvic floor muscle training in UI patients, as well as follow-up care after surgical treatments of stress urinary incontinence or pelvic organ prolapse. The methodological quality of most of the reports was good.
Telehealth has been implemented successfully in selected patients with PCa, UI, pelvic organ prolapse, uncomplicated urinary stones, and UTIs. Many urological conditions are suitable for telehealth, but more studies are needed on other highly prevalent urological malignant and benign conditions. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine. More robust data on long-term efficacy, safety, and health economics are necessary.
The diffusion of coronavirus disease 2019 (COVID-19) infections has recently increased the interest in telehealth, which is the adoption of telecommunication to deliver any health care activity. The available literature indicates that telemedicine has been adopted successfully in selected patients with several common clinical urological conditions, including prostate cancer, uncomplicated urinary stones, uncomplicated urinary infections, urinary incontinence, or pelvic organ prolapse. Likely, the COVID-19 pandemic will give a significant boost to the use of telemedicine, but more robust data on long-term efficacy, safety, and costs are necessary.
2019 年冠状病毒病（COVID-19）大流行导致人们对远程医疗的应用产生了更大的兴趣，以便在不使患者和医生面临感染风险的情况下提供医疗服务。关于该主题的泌尿科文献很少。
对文献进行系统评价，并评估所有关于远程医疗在泌尿科应用的现有研究。
在 PROSPERO 上注册后，我们在 PubMed 和 Scopus 数据库中搜索了任何评估任何泌尿科疾病中远程医疗干预的研究。使用国家毒理学计划/健康评估和翻译风险的偏倚评估工具对人类和动物研究进行风险评估。进行了叙述性综合。
我们确定了 45 项研究（11 项涉及前列腺癌[PCa]，3 项血尿管理，6 项尿路结石，14 项尿失禁[UI]，5 项尿路感染[UTI]和 6 项其他疾病），包括 12 项随机对照试验。现有文献表明，远程医疗已在多种常见临床情况下成功实施，包括非转移性 PCa 诊断后的决策过程，根治性治疗后局限性 PCa 患者的随访，初始血尿诊断，非复杂性尿路结石和非复杂性 UTI 的诊断和随访治疗，以及 UI 患者的初始评估，行为疗法和骨盆底肌肉训练，以及压力性尿失禁或盆腔器官脱垂的外科治疗后的随访。大多数报告的方法学质量良好。
远程医疗已在选定的 PCa、UI、盆腔器官脱垂、非复杂性尿路结石和 UTI 患者中成功实施。许多泌尿科疾病都适合远程医疗，但需要更多研究来研究其他高发的泌尿科恶性和良性疾病。很可能，COVID-19 大流行将极大地促进远程医疗的使用。需要有关长期疗效，安全性和健康经济学的更可靠数据。
2019 年冠状病毒病（COVID-19）感染的扩散最近增加了对远程医疗的兴趣，远程医疗是通过电信提供任何医疗保健活动。现有文献表明，远程医疗已在几种常见的泌尿科临床疾病中成功应用于选定的患者，包括前列腺癌，简单的尿路结石，简单的尿路感染，尿失禁或盆腔器官脱垂。很可能，COVID-19 大流行将极大地促进远程医疗的使用，但是需要有关长期疗效，安全性和成本的更可靠数据。
