Urology journal
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This study aimed to investigate the impact of COVID-19 on urology practice in Indonesia. ⋯ The COVID-19 pandemic has caused a decline in urology service in both outpatient clinic and surgery services with uro-oncological procedure as a priority to conduct.
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Review
Urologists and the Novel Coronavirus Disease 2019 (COVID-19): a Urologist's Perspective from China.
No need for letter to the editor.
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Novel coronavirus Disease (Covid-19) has emerged in Wuhan, China in December 2019 and became a pandemic in a few weeks. In this review, we aimed to summarize the current urologic practice trends worldwide to help urologist in decision making in disasters particularly in Covid-19 pandemic. ⋯ We have performed a PubMed and Internet search by using the keywords: 'Covid', 'new coronavirus', 'coronavirus urology, 'covid urology' without a date restriction. Results: All elective surgeries for benign urological conditions such as urinary tract stone disease that not caused complicated obstruction, benign prostate enlargement, infertility, incontinence and genitourinary prolapse, erectile dysfunction undescendent testis, vesico-ureteral reflux should be postponed till the lasting of Covid-19 outbreak. In obstructing ureteral stone both nephrostomy tube and double-J stent insertion are valid management options. However, one must consider that these procedures must be performed under local anesthesia when possible to spare a ventilator. When deferring urooncological operations and treatments oncological outcomes must be considered. Aggressive cessation or reducing the dosage of immunosuppressant therapy might be an option in renal transplanted patients with severe pneumonia or acute respiratory distress syndrome.
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Prostate cancer is a major worldwide health concern with up to 60% of patients experiencing biochemical relapse after radical treatment. Introduction of prostate-specific membrane antigen (PSMA)-based radiotracers for imaging and therapy had gained increasing attention in recent years. Positron emission tomography (PET) imaging with Ga68 PSMA is the most promising technique, but PSMA-based radiotracers SPECT imaging with low dose of 177Lu-PSMA when PET imaging is not available may also be considered. The goal of the study is to evaluate the sensitivity of 177Lu_psma for detection of metastatic sites in patients with biochemical relapse and negative conventional (MRI, MRS, CT scan and bone scintigraphy) imaging. ⋯ 177Lu-PSMA SPECT scan can help detecting metastatic lesions in more than one third of patients with biochemical recurrence and negative conventional investigations, when 68Ga- PSMA PET is not available.