Reconstructive surgery protocol recommendations during COVID-19 pandemia./ Recomendaciones de actuacion en cirugia reconstructiva urologica durante la pandemia Covid-19

OBJECTIVES: Offer some recommendations or guidelines during the evolution of the COVID-19 pandemic in terms of diagnosis, treatment and follow-upin the field of Reconstructive Urology MATERIAL AND METHOD: The document is based on the evidence on SARS/Cov-2 and the authors' experience in managing COVID-19 in their institutions, including specialists from Andalusia, Madrid, Cantabria,the Valencian Community and Catalonia A web and PubMed search was performed using "SARS-CoV-2", "COVID-19", "COVID-19 Urology", "COVID19 urology complications", "COVID-19 reconstructive surgery" A narrative review of the literature was carried out (5/17/2020) and after the nominal group technique modified due to the extraordinary restrictions, a first draft was made to unify criteria and reach a quick consensus Finally, a definitive version was made, agreed by all the authors (5/22/2020) RESULTS: The authors defined the following surgical priorities for Urological Reconstructive Surgery: Emergency/Urgency (life-threatening or emergencies still in anormal situation), Elective Urgency/High priority (potentially dangerous pathology if postponed for more than 1month), Elective Surgery/Intermediate priority (pathology with little probability of being dangerous but it is recommended not to delay more than 6 months), Delayed surgery/Low priority (non-dangerous pathology if it is postponed for more than 6 months) According to this classification, the Working Group agreed on the distribution of the different surgical scenarios of Reconstructive Urology In addition, consensus was reached on recommendations regarding the diagnosis and follow-up of pathology in the field of Reconstructive Urology CONCLUSIONS: Tools should be implemented to facilitate the gathering of the medical visit and diagnostic tests Redistribution of surgical procedures based on priority degrees is necessary during the pandemic and transition period The use of telemedicine is essential forfollow-up, by computer, telephone or videoconference OBJETIVOS: Establecer unas recomendaciones o guia de actuacion durante la evolucion de la pandemia COVID-19 en cuanto al diagnostico, tratamiento y seguimiento en el campo de la Urologia Reconstructiva MATERIAL y METODO: El documento se basa en la evidencia sobre SARS/Cov-2 y la experiencia de los autores en el manejo de COVID-19 en sus instituciones, incluyendo especialistas de Andalucia, Madrid, Cantabria, Comunidad Valenciana y Cataluna Se realizo una busqueda web y en PubMed utilizando SARS-CoV-2, COVID-19, COVID-19 Urology, COVID19 urology complications, COVID-19 reconstructive surgery Se realizo una revision narrativa dela literatura (17/5/2020) y tras la tecnica de grupo nominal modificada debido a las restricciones extraordinarias, se realizo un primer borrador para unificar criterios y llegar a un rapido consenso Finalmente, se realizo una version definitiva, consensuada por todoslos autores el 22/5/2020 RESULTADOS: Los autores definieron para la Cirugia Urologica Reconstructiva las siguientes prioridades quirurgicas: Emergencia/Urgencia (Riesgo vital o urgencias aun en situacion de normalidad), Urgencia Electiva/Alta prioridad (Patologia potencialmente peligros asi se pospone mas de 1 mes), Cirugia Electiva/Prioridad intermedia (Patologia con poca probabilidad de ser peligrosa pero se recomienda no retrasar mas de 6 meses), Cirugia demorable/Baja prioridad (Patologia no peligrosa si se pospone mas de 6 meses) Acorde a esta clasificacion, el Grupo de Trabajo consensuo la distribucion de los diferentes escenarios quirurgicos de la Urologia Reconstructiva Ademas, se llego a consenso sobre recomendaciones en cuanto al diagnostico y seguimiento de la patologia en el ambito de la Urologia Reconstructiva CONCLUSIONES: Deben implementarse mecanismos que faciliten la agrupacion de la visita medica y pruebas diagnosticas La redistribucion de los procedimientos quirurgicos en funcion de los grados de prioridad es imprescindible durante el periodo de pandemia y de transicion El empleo de la telemedicina es necesario para el segu miento, mediante via informatica, telefonica o videoconferencia