於筆者撰文之際，COVID-19已經造成全世界超過9620萬人次的感染以及至少206萬人死亡，而且每日新增的確診數量於筆者撰文之際甚至高達單日超過60萬人的確診數量，儘管在衛服部的有效檢疫政策之下我們幾乎與世界各國處於安全的環境平行時空，但台灣在近日爆發的醫院群聚感染仍然令人感到憂心，在這樣難以想像的全球疫情肆虐下彷彿看不到疫情的終結時間點，更是令人擔心在面對受到COVID-19感染或疑似感染的病人處置上，該怎麼決策是否進行我們原本臨床上進行的處置或是如何選擇進行那些檢測以及實在需要進行檢測時如何進行合宜的防護，在這篇完整的文獻評論中，作者群透過實證醫學的方式蒐集文獻並且給予針對婦女泌尿與功能性泌尿的患者在臨床處置上許多有深度且有實際價值的建議，我想作為各位閱讀本文的尿失禁協會會員會是未來面對疑似案例的處置上非常重要的資訊。

在本文章中，作者開宗明義便明示在此疫情肆虐之下，基於此病毒的極高度傳染性，已經染疫或是疑似染疫的婦女泌尿與功能性泌尿病患，必須明瞭到原本的疾病所造成的生活品質下降的情況在可以忍受的情況會高度建議暫時不要接受任何處置與診療，由於各種診療的接觸無論是非侵入性的檢測(包括尿流速、尿液檢驗、尿墊測試)，或是侵入性的檢測(包括理學檢查、膀胱鏡、各種超音波、各種尿路動力學檢測、更換與放置膀胱造廔或尿管、移除各式導管與輸尿管導管、子宮托的更換、經皮脛神經刺激、神經阻斷、自我單導的教學、尿道擴張、骨盆腔底肌肉的訓練等等)，在此處置指引上都建議由於並不會危及生命安全都建議COVID-19感染或高度疑似感染患者先暫緩上述處置，而若有症狀者均建議接受處置後出院，再次隔離14天之後且完全沒有任何相關症狀才接受上述處置。而若實在逼不得已需進行上述檢測，病患均需配戴完整醫療用口罩與可能搭配手套，於醫療人員端則在「非侵入性類別檢測」時穿戴「手術口罩，圍裙和手套」且「考慮搭配護目鏡」，而若執行「侵入性類別檢測」雖然病患配戴同樣的完整醫療用口罩與可能搭配手套，但醫療人員需穿戴「完整的個人防護設備，包括鞋套，防滲服，手術或N95口罩，防護頭套，手套和護目鏡」。

儘管在本文獻中提到，尿液中病毒的表現量極低，以及先前文獻於女性生殖器官內似乎也沒有偵測到病毒，於陰道分泌物中無論呼吸道的病毒量與臨床嚴重程度也完全都沒有發現到病毒量的表現，但是因為呼吸道與腸道(包括糞便)的大量病毒量表現量與傳染性，仍然盡可能減少與感染或疑似感染病患的接觸，因次在本文中也將各式各樣可能在婦女泌尿或功能性泌尿病患中可能出現的手術與情境依照判斷危急程度分成四級，除了可能影響生命徵象的手術或是會影響到感染控制間接影響到生命類別的手術，大多手術常見的均建議可延遲數月，甚至是等疫情尾聲或結束再行接受手術處置。而許多包括骨盆腔底的肌肉訓練或是學習與訓練自我單導等處置，在本文也建議如果仍然需要進行處置則均暫時建議以導尿管置入減少與病患的接觸而增加暴露造成感染風險上升，於本文中也有提到需要與病患接觸的過程透過遠距的電話問診或是視訊問診也能夠減少直接與病患接觸。

儘管病患的生活品質可能因為延後手術處置而低落，然而在此高度傳染性且國外的單日確診量仍然逐步上升的現今情境，依然認為病患應該優先延遲處置並且使醫師減少暴露感染的風險直至疫情緩解或結束，依照這樣的原則相信對於各位會員面對病患或疑似病患也有一定的準備，期許大家都能平安度過疫情。

Context
Coronavirus disease 19 (COVID-19) has changed standard urology practice around the world. The situation is affecting not only uro-oncological patients but also patients with benign and disabling conditions who are suffering delays in medical attention that impact their quality of life.

Objective
To propose, based on expert advice and current evidence where available, a strategy to reorganize female and functional urological (FFU) activity (diagnosis and treatment).

Evidence acquisition
The present document is based on a narrative review of the limited data available in the urological literature on SARS-Cov-2 and the experience of FFU experts from several countries around the world.

Evidence synthesis
In all the treatment schemes proposed in the literature on the COVID-19 pandemic, FFU surgery is not adequately covered and usually grouped into the category that is not urgent or can be delayed, but in a sustained pandemic scenario there are cases that cannot be delayed that should be considered for surgery as a priority. The aim of this document is to provide a detailed management plan for noninvasive and invasive FFU consultations, investigations, and operations. A classification of FFU surgical activity by indication and urgency is proposed, as well as recommendations adopted from the literature for good surgical practice and by surgical approach in FFU in the COVID-19 era.

Conclusions
Functional, benign, and pelvic floor conditions have often been considered suitable for delay in challenging times. The long-term implications of this reduction in functional urology clinical activity are currently unknown. This document will help functional urology departments to reorganize their activity to best serve their patients.

Patient summary
Many patients will suffer delays in urology treatment because of COVID-19, with consequent impairment of their physical and psychological health and deterioration of their quality of life. Efforts should be made to minimize the burden for this patient group, without endangering patients and health care workers.