Urologic Services in Public Hospitals Suffered a Greater Detriment Than Private Hospitals During the Battle of COVID-19

Ong, William; Lechmiannandan, Sivaneswaran; Loeb, Stacy; Teoh, Jeremy Yuen‐Chun

doi:10.1016/j.urology.2020.07.010

Cited by 8 publications

(7 citation statements)

References 2 publications

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“…To minimize the risk of infection and to divert resources to manage COVID-19 patients, the provision of surgical services including outpatient clinics, investigations, and operations have been significantly cut down. 1 , 2 …”

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confidence: 99%

“…Moreover, many hospitals have experienced manpower shortages, and surgeons have been deployed to manage COVID-19 patients either in a voluntary or mandatory basis. 1,2 The infective risks of COVID-19 are imposed not only to surgical staff themselves, but also to their family members. 5,6 There have been a few local reports addressing the psychological impact of the COVID-19 pandemic on healthcare workers.…”

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confidence: 99%

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Psychological Health of Surgeons in a Time of COVID-19

Tan¹,

Wang²,

Yap³

et al. 2021

Annals of Surgery

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Objective: To assess the degree of psychological impact among surgical providers during the COVID-19 pandemic. Summary of Background Data: The COVID-19 pandemic has extensively impacted global healthcare systems. We hypothesized that the degree of psychological impact would be higher for surgical providers deployed for COVID-19 work, certain surgical specialties, and for those who knew of someone diagnosed with, or who died, of COVID-19. Methods: We conducted a global web-based survey to investigate the psychological impact of COVID-19. The primary outcomes were the depression anxiety stress scale-21 and Impact of Event Scale-Revised scores. Results: A total of 4283 participants from 101 countries responded. 32.8%, 30.8%, 25.9%, and 24.0% screened positive for depression, anxiety, stress, and PTSD respectively. Respondents who knew someone who died of COVID-19 were more likely to screen positive for depression, anxiety, stress, and PTSD (OR 1.3, 1.6, 1.4, 1.7 respectively, all P < 0.05). Respondents who knew of someone diagnosed with COVID-19 were more likely to screen positive for depression, stress, and PTSD (OR 1.2, 1.2, and 1.3 respectively, all P < 0.05). Surgical specialties that operated in the head and neck region had higher psychological distress among its surgeons. Deployment for COVID- 19-related work was not associated with increased psychological distress. Conclusions: The COVID-19 pandemic may have a mental health legacy outlasting its course. The long-term impact of this ongoing traumatic event underscores the importance of longitudinal mental health care for healthcare personnel, with particular attention to those who know of someone diagnosed with, or who died of COVID-19.

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Psychological Health of Surgeons in a Time of COVID-19

Tan¹,

Wang²,

Yap³

et al. 2021

Annals of Surgery

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“…Our study was limited by several factors, one of which was the small sample size. However, we managed to achieve the minimum required number of subjects to power the study, particularly during this unprecedented COVID‐19 pandemic as most of the urology outpatient appointments were significantly cut down (Ong et al, 2020). Despite there was a significant difference in baseline characteristics with regards to history of dyslipidemia between the two groups, additional sub‐analysis will be required in future to determine whether LiSWT provides the same advantages regardless of independent comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Early outcomes of short‐course low intensity shockwave therapy ( LiSWT ) for erectile dysfunction: A prospective, randomized, double‐blinded, sham‐controlled study in Malaysia

Keat¹,

Lechmiannandan

Lim³

et al. 2022

Andrologia

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Low-intensity shockwave therapy (LiSWT) has emerged as a promising non-invasive treatment modality for erectile dysfunction (ED) yet the well-designed randomized clinical trials are still lacking to prove its claimed benefits. A randomized, prospective, double-blinded sham-controlled study was conducted to evaluate the effectiveness and safety profile of short course LiSWT on vasculogenic ED patients. The International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) questionnaires were used for evaluation. Patients underwent weekly sessions for 4 weeks and were re-assessed at 1, 3 and 6 months post therapy. Fifty one patients were recruited and randomized into sham and treatment arms. The mean IIEF-5 scores were significantly improved in the treatment arm compared to worsening of scores in the sham arm after 1 month (14.1 vs. 9.3 p < 0.001), 3 months (14.9 vs. 8.6, p < 0.001) and 6 months (14.2 vs. 7.9, p < 0.001) post treatment. A significant improvement of EHS was demonstrated at 1 month (2.4 vs. 1.8, p = 0.001, 3 months 2.7 vs. 1.7, p < 0.001) and 6 months (2.7 vs. 1.6, p < 0.001) in the treatment arm compared to sham arm. The success rate based on IIEF score increment more than five points was 26% in treatment arm and 0% in sham arm. Improvement in EHS score ≥3 in the treatment versus sham arm was 63% and 4%, respectively.There was no adverse effect reported. This 4-week LiSWT protocol reflects better treatment compliance, and it prevents further deterioration of erectile function among this cohort of patients. This study proves that LiSWT is a well-tolerated treatment with modest improvements in erectile function and hardness, among patients with vasculogenic ED.

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“…The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic emerged in December 2019 and has resulted in redistribution of healthcare resources to address the pandemic. This has resulted in cancelation of elective surgeries worldwide ( 10 , 11 ). Many hospitals have deferred elective and non-cancer surgery, while prioritizing emergency cases and select high-risk oncological cases.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis on delaying surgery for urothelial carcinoma of bladder and upper tract urothelial carcinoma: Implications for the COVID19 pandemic and beyond

Leow¹,

Tan²,

Tan³

et al. 2022

Front. Surg.

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PurposeThe COVID-19 pandemic has led to competing strains on hospital resources and healthcare personnel. Patients with newly diagnosed invasive urothelial carcinomas of bladder (UCB) upper tract (UTUC) may experience delays to definitive radical cystectomy (RC) or radical nephro-ureterectomy (RNU) respectively. We evaluate the impact of delaying definitive surgery on survival outcomes for invasive UCB and UTUC.MethodsWe searched for all studies investigating delayed urologic cancer surgery in Medline and Embase up to June 2020. A systematic review and meta-analysis was performed.ResultsWe identified a total of 30 studies with 32,591 patients. Across 13 studies (n = 12,201), a delay from diagnosis of bladder cancer/TURBT to RC was associated with poorer overall survival (HR 1.25, 95% CI: 1.09–1.45, p = 0.002). For patients who underwent neoadjuvant chemotherapy before RC, across the 5 studies (n = 4,316 patients), a delay between neoadjuvant chemotherapy and radical cystectomy was not found to be significantly associated with overall survival (pooled HR 1.37, 95% CI: 0.96–1.94, p = 0.08). For UTUC, 6 studies (n = 4,629) found that delay between diagnosis of UTUC to RNU was associated with poorer overall survival (pooled HR 1.55, 95% CI: 1.19–2.02, p = 0.001) and cancer-specific survival (pooled HR of 2.56, 95% CI: 1.50–4.37, p = 0.001). Limitations included between-study heterogeneity, particularly in the definitions of delay cut-off periods between diagnosis to surgery.ConclusionsA delay from diagnosis of UCB or UTUC to definitive RC or RNU was associated with poorer survival outcomes. This was not the case for patients who received neoadjuvant chemotherapy.

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Urologic Services in Public Hospitals Suffered a Greater Detriment Than Private Hospitals During the Battle of COVID-19

Cited by 8 publications

References 2 publications

Psychological Health of Surgeons in a Time of COVID-19

Psychological Health of Surgeons in a Time of COVID-19

Early outcomes of short‐course low intensity shockwave therapy ( LiSWT ) for erectile dysfunction: A prospective, randomized, double‐blinded, sham‐controlled study in Malaysia

A systematic review and meta-analysis on delaying surgery for urothelial carcinoma of bladder and upper tract urothelial carcinoma: Implications for the COVID19 pandemic and beyond

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