Experience with teleurology in the diagnosis of urologic neoplasias at a hospital in Northern Mexico

Abstract

Background: Genitourinary cancer is a great health problem worldwide, and mortality rates are higher in less developed countries. Mexico’s geographic distribution is complex, making it difficult to provide health services to rural communities. In the present study, we present the experience in providing medical services to remote communities through telemedicine, mainly in relation to the diagnosis of urologic neoplasias. By sharing our experience, we hope the program, as well as the process of primary care diagnosis of urologic neoplasias, can be improved, enhancing opportune patient referral.
 Materials and Methods: A retrospective, descriptive analysis of the urology consultations carried out by the urology service personnel through telemedicine, within the time frame of January 2009 to May 2017, was conducted. The case records of patients suspected of urologic neoplasia were examined and the data of patients in whom the diagnosis was confirmed were analyzed.
 Results: A total of 1,265 consultations were given by the urology service through telemedicine during the study period. Of those, 696 were first-time consultations and the rest were subsequent appointments. Fifty-nine patients were suspected of having genitourinary cancer (8% of the first-time consultations) and the disease was confirmed in 17 patients (2% of the first-time consultations). The most prevalent neoplasia was prostate cancer, presenting in 6 patients (35%), and the remaining cases corresponded to bladder cancer (29%), penile cancer (12%), testicular cancer (12%), kidney cancer (6%), and urothelial cancer of the upper urinary tract (6%). Mean patient age was 65.7 years, with a predominance of men (n = 15). The majority of cases were diagnosed in clinically advanced stages.
 Conclusion: In our experience, the role of telemedicine was limited, regarding the opportune diagnosis of genitourinary cancer, given that the majority of cases analyzed were diagnosed in advanced stages.