key: cord-0903907-y51ksqr9
authors: Kelly, N. P.; Casey, R. G.
title: Abstract 42 Impact of COVID-19 on a one-stop haematuria clinic
date: 2021-09-30
journal: European Urology Open Science
DOI: 10.1016/s2666-1683(21)00208-1
sha: 301d8661c70490a2d252a0ab957045d930d823cb
doc_id: 903907
cord_uid: y51ksqr9

nan

Results: Elevated HERV-K gag mRNA expression predicts a PCa diagnosis (OR 6.1 95%CI 3.7-9.7). HERV-K gag protein expression was elevated in PCa versus BPH (Fisher exact test, p = 0.001). A nonsignificant increase in IFN-γ ( p = 0.238) and IFN-β ( p = 0.147) plasma levels was seen. Decreasing levels of IFN-γ were found with increasing ISUP grade ( p = 0.351) and primary pattern ( p = 0.033). Conversely, increasing levels of IFN-β were found with increasing ISUP grade ( p = 0.212) and primary pattern ( p = 0.129). Conclusions: HERV-K is significantly elevated in men with PCa. IFN-γ and IFN-β are involved in anti-viral responses. Decreasing IFN-γ levels seen with increased ISUP grade may represent deregulation of IFN-γ anti-tumour immune responses in high-grade disease. Conversely, increased IFN-β levels may represent increased HERV-K activation of type I IFN response in high-grade disease. We speculate an inflamed state, with increased HERV-K activation may contribute to more aggressive disease.

Impact of COVID-19 on a one-stop haematuria clinic N.P. Kelly 1 , R.G. Casey 1 1 Department of Urology, Tallaght University Hospital, Dublin 24, Ireland

Introduction: The One-stop haematuria clinic (OSHC) at Tallaght Hospital has been in situ for over 10 years, allowing multi-modality assessment (flexible cystoscopy and renal ultrasound) of haematuria in a single visit. The recent impact of Covid-19 led to a dramatic reduction in the number of patients seen in our hospitals 1 . We report the impact of service reductions on our haematuria clinic. Methods: A retrospective review of medical notes of patients scheduled to attend the haematuria clinic during the calendar year 2020 were reviewed, comparing a pre-( prior to March 2020) and post-Covid era.

Results: In the pre-Covid era, 56 patients were offered appointments at the OSHC with 84% attending. 96% had a same day ultrasound and 64% were discharged after a single visit. 10% had subsequent CT urogram scans. No cancers were detected in this cohort.

In the post-Covid setting, 230 patients were offered appointments with 60% attending. Only 56% had same day ultrasound and only 36% were discharged after a single visit. 10 bladder cancers and 1 renal cancer were detected. There was increased utilisation of same-day CT scanning but also increased use of subsequent CT urograms (18%). Return visits to outpatients from 21% pre-covid to 46% post-covid. Of these, 25% were to review imaging results.

The Covid crisis has led to a decrease in the efficiency of the OSHC. Attempts to minimise patients potential exposure to Covid-19 has had the unintended effect of increasing the number of visits required to get a diagnosis. Methods: Seven patients diagnosed with primary urethral carcinoma of the distal urethra were identified using a prospectively maintained penile cancer database at our institution from May 2017 to November 2020.

Results: The mean age at presentation was 56.5 (33-80) years. Presenting symptoms included visible lesion, LUTs and a groin mass. Three patients had lesions located within the glanular urethra and had a distal urethrectomy and primary closure. Two patients with lesions extending proximal to the glanular urethra and into or beyond the fossa navicularis had a distal urethrectomy with a hypospadic neomeatus formation. One patient with tumour extending into the glans penis underwent distal urethrectomy and partial glansectomy with split thickness skin graft. A partial penectomy was performed for one patient with urethral tumour invading the corporal heads. Mean follow-up was 23.4 (±17.0) months. There have been no recurrences recorded to date. Conclusion: Penile preserving techniques are feasible in patients with tumours of the pendulous urethra and do not appear to compromise local control.

Penile-preserving surgery for male distal urethral carcinoma