What should urologists know about SARS-CoV-2? Risk analysis for urological operations and recommendations for action in clinical routine

Urologe A. 2020 Oct 13. doi: 10.1007/s00120-020-01264-z. Online ahead of print.


BACKGROUND: COVID-19 poses a challenge to healthcare systems worldwide. Due to the increasing number of cases, surgeons in urology have also been confronted with SARS-CoV‑2 infections. Thus, there is an urgent need for clinical guidance and recommendations.

AIM: Our work aims to create a widespread assessment of a possible risk for infection with SARS-CoV‑2 during surgical procedures. Based on current data and current national and international guidelines, we try to assess the risk of infection when handling human tissue and the necessary hygienic measures that are needed. Finally, recommendations for daily urologic work are derived and explained.

MATERIALS AND METHODS: The current literature in PubMed, bioRxiv and medRxiv and data available from the WHO and Robert-Koch-Institut on SARS-CoV‑2 and surgical procedures in (potentially) infected patients are reviewed. The endpoint of our research was 21 April 2020.

CONCLUSION: Based on our research, general and specific recommendations for clinical urologic praxis can be derived. Although it remains unclear whether SARS-CoV‑2 is transmitted via the aerosols produced, current PPE in operating rooms probably does not offer sufficient protection during surgical interventions during the SARS-CoV‑2 pandemic. Use of FFP‑2 masks, safety goggles and full-body protective suits is crucial. To contain viral spread on surfaces and personnel, complex filter systems (HEPA) should be used as well as closed suction devices during surgery. Combined with consequent disinfection of surfaces and behavioral measures, a safe environment for healthcare workers in urology can be created. Thus, according to current knowledge, we believe that emergency and urgent surgical procedures are not contraindicated, provided that appropriate precautionary safety measures are followed.

PMID:33048213 | DOI:10.1007/s00120-020-01264-z