Modern Approaches to Examination of Andrological and Sexological Patients During Covid-pandemia

Abstract

Rapid increase in the overall incidence of pathologies of the reproductive and genitourinary systems in the conditions of a covid epidemic is predictable and requires certain medical and social steps (the formation of a preventive direction of treatment, the restoration of dispensary observation measures, the introduction of social health programs, the ability of citizens to receive qualified and timely specialized medical care etc.). The global spread of the SARS-CoV-2 coronavirus has led to a restriction in the provision of specialized urological care at the time of lockdown, which also negatively affected the dynamic examination of patients, due to a decrease in scheduled examinations. Remotely provided medical recommendations are not always correct due to the lack of the possibility of direct examination of the patient by a doctor. Significant assistance in the classification of patient complaints with the indicated clinical groups of symptoms is provided by questionnaires using generally recognized questionnaires, which must be used when interviewing each patient to establish a clinical syndrome, and it is possible to get a general idea of the state of human health only through a comprehensive analysis of the questionnaire data. The diagnosis by a doctor is established according to the anamnesis in 50% of cases, on the basis of clinical observation – in 30% and according to laboratory data – in 20%. The first remote contact of such patients with a doctor should include a detailed questioning of complaints, a review of the medical history, a review of his own medical, sometimes auto photographic, materials. Such men should always be examined on a second visit. In conditions of remote examination with lockdown, all the above examinations of patients with androgen deficiency are difficult to carry out, therefore, a less short diagnostic protocol can be applied, which will include the data: 1) ultrasound scan of the thyroid gland, abdominal organs, retroperitoneal space, small pelvis, scrotum; 2) data from clinical and laboratory tests. It is mandatory to provide medical information about the somatic and mental (psychological) state of the patient. Andrological patients usually do not have emergency conditions, but diagnostics, especially prescribing treatment, is a painstaking and individually directed process, therefore remote medical procedures are not the best option and require direct contact between the doctor and the patient.