Telemedicine for patients with urogynecologic conditions (research up to 31 March 2020)
Citation: Grimes C, Balk E, Crisp C, et al. A guide for urogynecologic patient care utilizing telemedicine during the COVID-19 pandemic: review of existing evidence. International Urogynecology Journal. 2020:31:1063-89.
What is this? The COVID-19 pandemic is placing a great strain on healthcare systems and increasing use is being made of telehealth.
In this rapid review, the authors searched for studies on the use of telemedicine for the treatment of outpatients with urogynecologic conditions during the COVID-19 pandemic. They restricted their searches to articles published in English and completed the searches on 31 March 2020. They identified 9 studies on telemedicine, 16 on pessary management, 60 on the empiric treatment of urinary tract infections, and 23 on voiding dysfunction and retention.
What was found: At the time of this review, the included studies showed that virtual visits are effective for established Female Pelvic Medicine and Reconstructive Surgery patients who do not require a physical examination or for follow-up visits of those who live in rural regions. Virtual discussions of alternative therapies and counseling were suggested as replacements to preoperative visits while these patients wait for surgery delayed by the COVID-19 pandemic and its associated measures.
At the time of this review, the included studies showed that patients can safely extend the time between pessary cleanings to 6 (and in some cases to 24 months) with minimal risk of adverse events. Patients who are able to remove and reinsert their pessary should be encouraged to self-clean the pessary. Empiric vaginal estrogen may help minimize adverse events for patients who do not already take vaginal estrogen.
At the time of this review, the included studies showed that telemedicine is effective and lower costs for patients with urinary tract infections but may lead to increased prescriptions.