Abstract
Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude.
The health care system is facing a tremendous challenge to provide ethical and quality
care. The transformation of the patient-based care to population-based care during
the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is
to explore the consensus in modified standard urology care, that can be adopted and
applied during COVID-19 and similar pandemic.
Methods We adopted an exploratory study design using secondary data. The data were extracted
from a web-based medical library using keywords “COVID-19,” “severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2),” and “urology.” We identify and extrapolate (screening,
eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic
standard urology care under four main themes: (1) general urology care, (2) choice
of surgical modality, (3) triage, and (4) urology training.
Result We identified 63 academic papers related to our research question. The majority are
expert opinions and perspectives on urology care. The common consensus is triage-based
urology care and surgeries. Life or organ threatening conditions need immediate attention.
Universal protective measures (personal protective equipment, safe operative environment)
and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection.
Conservation of the resources and its rational distribution provide an ethical basis
for population-based health care during a pandemic. Informed decision making serves
best to patients, families, and society during the public health crisis.
Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard
population-based care. The consensus in crisis is drawn from evolving pieces of medical
evidence and public health ethics. The provision of urology care during a pandemic
is based on the availability of resources; severity of the disease, consequences of
deferment of service, and dynamics of the pandemic.
Keywords
COVID-19 - infection - pandemic - urology - standard urology care
