Table 2. Summary of suggested triage of urological surgical cases during the COVID-19 pandemic by Stensland et al. ( 8 ).
| Condition | Pathology | Treatment Recommended | Comments | |
|---|---|---|---|---|
| Stensland et at , ( 8 ) | Bladder cancer | MIBC (regardless CHT)-refractory CIS (3rd line) | Radical cystectomy | 5-8 days' hospital stay |
| Suspected >cT1 BC | TURB | Outpatient procedure | ||
| Testicular cancer | Suspected testicular cancer | Orchiectomy | Outpatient procedure | |
| Post-CHT LN (testicular cancer). | RPLN dissection - RT/CHT post-orchiectomy (if clinically appropriate) | Balance CHT (immunosuppression). | ||
| Renal tumor | ≥cT3 renal tumor | Radical nephrectomy + thrombectomy | ||
| cT1 renal tumor | Delay surgery / Ablative approach | |||
| cT2 renal tumor | Delay surgery up to 3 months | |||
| Prostate cancer | PCa high-risk | RT - Surgery (if ineligible for RT) -delay in selected cases | Most prostatectomy should be delayed | |
| PCa intermediate/low risk | Delay surgery | |||
| Upper urinary tract cancer | High grade ≥cT1 UTUC | Nephroureterectomy | 1 - 4 days of hospital stay | |
| Adrenal tumor | Adrenal tumor >6 cm (suspected for carcinoma) | Adrenalectomy | 0 - 1 day of hospital stay | |
| Adrenal tumor <6 cm. | Consider to delay | Possible rapid progression | ||
| Urethral/penile tumor | Urethral/penile invasive or obstructive cancer | Limited data, consider partial penile penectomy, avoid LN dissection | Outpatient procedure | |
| Endourology | Stones | Nephrostomy/stent (preferable under local anaesthesia) | Emergency if obstructive/infected | |
| Indwelling ureteral stent | Delay most procedures (from 6-12 to 30 months) | Outpatient procedure | ||
| BPH | Only if obstructive suprapubic/urethral catheter | |||
| Female urology/ incontinence | Urinary incontinence | Delay all procedures | High risk of infection | |
| Cystitis | Delay all procedures | |||
| OAB | Delay all procedures | |||
| Neurogenic Bladder | Delay all procedures | |||
| External nerve stimulator | Internalized or removed | |||
| Reconstructive surgery | Fistula with pelvic sepsis | Urine/fecal diversion (delay definitive repair) | ||
| Infected urinary sphincter | Explantation | |||
| Urethral stricture | Urethral obstruction | Suprapubic/urethral catheter | Outpatient procedure | |
| Prosthetic surgery | Penile prosthesis | Explant if infected | ||
| General urology | Priapism | Shunt | Outpatient procedure | |
| Spermatic cord torsion | Detorsion/orchidopexy | |||
| Refractary gross hematuria | Clot evacuation | |||
| Acute scrotal abscess and Fournier's gangrene | Surgery | |||
| Penile/testicular fracture | Surgery | |||
| Ureteral injury | Surgery | |||
| Bladder perforation | Surgery | |||
| Transplant | Renal transplant | Deceased donor, don't delay Live donor, delay | ||
| Infertility | Infertilty | Delay all procedures |
MIBC = muscle-invasive bladder cancer; BC = bladder cancer; CHT: = chemotherapy; TURB = trans-urethral resection of bladder; LN = lymphnodes: RPLN = retroperitoneal lymphnodes; RT = radiation therapy; PCa = prostate cancer; BPH = benign prostate hyperplasya; OAB = overactive bladder