The Use of Telemedicine for the Postoperative Urological Care of Children: Results of a Pilot Program

Benefits and barriers to pediatric tele-urology during the COVID-19 pandemic

“…Other conditions such as identifying a urethrocutaneous fistula or meatal stenosis after hypospadias repair may be quite challenging. From our secondary outcome, we found that post-operative visits were quite amenable to VV as previously demonstrated by others [6], with no difficulties in examination; however 43% of exams were considered inadequate on initial visits that were reliant on the physical exam. While the number of difficult exams was small, it highlights that certain conditions are better suited for telemedicine compared to others.…”

“…A previous pediatric urology telemedicine investigation by Finkelstein et al. found a similar rate of 96% [ 6 ]. No patients in the study had previous telemedicine visits with our practice, so the technical success rate did not benefit from patient experience with previous pediatric urology telemedicine visits.…”

“…Prior to the COVID-19 pandemic, telemedicine was an under-utilized form of delivering health care in the field of pediatric urology [ 10 ]. Prior studies have demonstrated successful telemedicine encounters for post-operative visits as well as for prenatal consultations on urologic conditions, most commonly including urinary tract dilation [ [5] , [6] , [7] ]. Out of necessity, the pandemic has changed the way practitioners have traditionally provided services in order to maintain quality care for pediatric urologic patients.…”

“…Telemedicine allows for the delivery of care while maintaining safe social-distancing measures. Remote video visits (VVs) have been used successfully for years in pediatric urology for the delivery of postoperative care [5,6] and prenatal urologic consultation [7]. Yet overall, there is a paucity of existing research on the use of telemedicine for general pediatric urologic conditions.…”

Forecasting Limited Access to Urology in Rural Communities: Analysis of the American Urological Association Census

“…38,39 Postoperative visits, and initial hematuria evaluations in particular, are ripe for innovation using telemedicine. 40,41 Some innovative groups go so far as to propose that registered nurses could perform "tele-cystoscopies" interpreted real time by board-certified urologists; the feasibility, safety, and legal implications of this approach are unknown and it remains an area of research. 42 Telesurgery may reduce geographic disparities to complex care in the far future, but legal, financial, and security concerns need to be addressed as well as making such a system palatable to a patient.…”