The genitourinary diseases health-care among patients and general practitioner

Abstract

Introduction: A general awareness of the most common genitourinary diseases is often lacking.The aim of the present study was to investigate the attention of the general practitioner and of the patient to the genitourinary diseases. An incomplete medical history and/or an inadequate physical examination might be responsible of late diagnosis and improper management. Patients and Methods: A self administered questionnaire was obtained by our outpatients before the urological visit. As a preliminary step we administered a very simple questionnaire consisting of four multiple choice questions: 1) Did your general practitioner examine your external genitalia in the last five years? Did you ask for this examination? 2) Did your general practitioner prescribe any clinical investigations? 3) Have you ever seen blood in your urine? Did you advise your doctor? 4) How long time did elapse between the first symptom and our councelling? The study should be closed if less than 5 patients among the first 20 showed an improper attention to genitourinary pathology, otherwise, 200 consecutive patients at least should be entered. A further structured interview was planned in the case of doubtful results. Results: From December 2011 to February 2012, 327 questionnaires were obtained from 358 patients with a compliance of 91.3%. The median age of the patients was 61 years (range: 15-91). Two hundred fiftyfive (78%) were men. Out of 327 patients only 72 (22%) underwent a physical examination comprehensive of the external genitalia in the previous five years. The remaining 250 (76.4%) patients were not examined and, more relevant, they did not ask for. Forty-nine (63.6%) out of the 77 patients were examined on their specific request. Only 172 (52.6%) patients underwent laboratory and/or imaging assessment before urological councelling. Gross haematuria was the main urological symptom in 91 (27.8%) of cases. The general practitioner was not adviced of patients’ symptom in 13% of cases and, when informed, a urological assessment was required in only 47%. Discussion and Conclusion: Our preliminary survey point out a limited attention to the genitourinary diseases both from the general practitioner and the patient. Noteworthy, in case of gross haematuria 20% of the patients did not inform the family doctor and a urological assessment was indicated in only 50% of cases.