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UGSA Surgical Guidelines during COVID-19 pandemic

April 4, 2020

Friday, 27 March 2020


Dear UGSA members,

We are writing to advise you that from 11.59pm tonight, 27 March 2020, all semi-urgent Category 2 and all Category 3 elective surgical procedures will be suspended at all surgical hospitals.

These guidelines are developed by UGSA as a general guide to assist our Australian members to make an informed decision during the Covid-19 pandemic.

Each clinician should use these guidelines to help with decision making in conjunction with the individual patient’s circumstances. As the situation is continually changing and evolving, the advice may vary over the next few days. We will review the document periodically and will amend as and when required.

The categorisation of surgery is as follows:

“Every patient waiting for elective surgery is assessed by their treating medical professional as Category 1, 2 or 3 per the following definitions:

  1. Category 1 – Needing treatment within 30 days. Has the potential to deteriorate quickly to the point where the patient’s situation may become an emergency
  2. Category 2 – Needing treatment within 90 days. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly and unlikely to become an emergency
  3. Category 3 – Needing treatment at some point in the next year. Their condition causes pain, dysfunction or disability. Unlikely to deteriorate quickly.

 Decisions on the category of patients are at the discretion of their treating medical professional.”

Urogynaecology surgery

Below is a list of conditions which are not exhaustive but serve as a guide for conditions which may warrant urgent surgical intervention.

Category 1

1) Ulcerated procidentia with bleeding

2) Prolapse causing hydronephrosis / urinary retention

3) Return to theatre for post-operative complications

Urgent Category 2

Significant voiding dysfunction/retention not managed with CISC.

  1. Haematuria for further investigations
  2. Complicated OASIS with infection or breakdown requiring revision of primary repair
  3. Pessary causing ulcerations/bleeding
  4. Severe bladder pain syndrome
  5. Leaking vesico-vaginal fistula
  6. Rectovaginal fistula needing EUA
  7. Recurrent UTIs (with past history of mesh) 
  8. Severe mesh pain
  9. Mesh erosion eroding into bladder/bowel

These guidelines will be reviewed regularly and monitored.

UGSA Board