Epsom and St Helier University Hospitals NHS Trust, Dorking Road, Epsom, KT18 7EG, UK.
St George's University of London, London, UK.
Int Urogynecol J. 2021 Oct;32(10):2631-2646. doi: 10.1007/s00192-021-04704-2. Epub 2021 Feb 3.
The coronavirus (COVID-19) pandemic has impacted health systems worldwide. There is a continuing need for clinicians to adapt practice to facilitate timely provision of medical care, whilst minimising horizontal transmission. Guidance and recommendations are increasingly available, and this rapid review aimed to provide a timely evidence synthesis on the current recommendations surrounding urogynaecological care.
We performed a literature review using PubMed/Medline, Embase and Cochrane and a manual search of national and international societies for management recommendations for urogynaecological patients during the COVID-19 pandemic.
Nine guidance documents and 17 articles, including 10 reviews, were included. Virtual clinics are recommended for new and follow-up patients, to assess and initiate treatment, as well as triage patients who require face-to-face appointments. Outpatient investigations such as urodynamics and cystoscopy for benign indications can be deferred. Prolapse and continence surgery should be suspended, except in specific circumstances such as procidentia with upper tract complications and failed pessaries. There is no evidence to support a particular route of surgery, but recommendations are made to minimise COVID-19 transmission.
Urogynaecological patients face particular challenges owing to inherent vulnerabilities of these populations. Behavioural and medical therapies should be recommended as first line options and initiated via virtual or remote clinics, which are integral to management during the COVID-19 pandemic. Expanding the availability and accessibility of technology will be increasingly required. The majority of outpatient and inpatient procedures can be deferred, but the longer-term effects of such practices are unclear.
冠状病毒（COVID-19）大流行已对全球卫生系统造成影响。临床医生需要不断调整实践，以便在尽量减少横向传播的同时及时提供医疗服务。目前有越来越多的指导和建议，本快速综述旨在就当前有关妇科泌尿学护理的建议提供及时的证据综合。
我们使用 PubMed/Medline、Embase 和 Cochrane 进行了文献综述，并对国家和国际学会的管理建议进行了手动搜索，以了解 COVID-19 大流行期间妇科泌尿患者的管理建议。
共纳入 9 份指南文件和 17 篇文章，包括 10 篇综述。建议为新患者和随访患者设立虚拟诊所，以评估和启动治疗，并对需要面对面就诊的患者进行分诊。良性指征的门诊检查，如尿动力学和膀胱镜检查，可以推迟。脱垂和控尿手术应暂停，除非在特定情况下，如伴有上尿路并发症的完全性子宫脱垂和失败的子宫托。没有证据支持特定的手术途径，但建议尽量减少 COVID-19 传播。
由于这些人群固有的脆弱性，妇科泌尿患者面临着特殊的挑战。行为和药物治疗应作为一线选择推荐，并通过虚拟或远程诊所启动，这是 COVID-19 大流行期间管理的重要组成部分。需要越来越多地扩大技术的可用性和可及性。大多数门诊和住院程序都可以推迟，但这种做法的长期影响尚不清楚。
