Introduction
Bladder cancer is the 11th most frequent tumor, presenting a high incidence in Spain. It is the 5th cancer that presents more expenses from a global perspective. Hematuria is the most common finding in bladder cancer and it is one of the most frequent queries that we present both at the emergency level and from primary care centers.
In the diagnosis, treatment and follow-up of bladder cancer we have not presented major changes in the last decades, so we have not seen an improvement in the overall survival of bladder cancer.
Objective:
Decrease the number of consultations and the time until the diagnosis of the patient, thus improving the oncological results (decrease in delay in diagnosis and early treatment of patients with infiltrating bladder muscle ca).
Material and methods:
Creation of a specific consultation of patients with monosymptomatic hematuria who do not present entry criteria. Patients are referred from the emergency service and from the virtual consultation. An initial consultation is carried out where a complete anamnesis, exploration, ultrasound +/- cystoscopy is carried out; making inclusion in the surgical waiting list if tumor pathology is objectified. If there is no pathology that justifies hematuria, UroTC is requested and the result is assessed in another consultation.
Results:
This is an initial project that began in August 2018. During this period, 157 virtual consultations were evaluated, identifying 10 patients who met the criteria of assessment in our high-resolution consultation. Likewise, 7 patients from the emergency service were assessed.
The average age of the patients is 71 years. The mean time from the first consultation for hematuria to the high resolution consultation was 5 days. The average time from the first consultation for hematuria to the consultation in specialized care center is approximately 4-5 months in case of appointment of first time / preferred appointment and 1-2 months in case of urgent appointment.
7 patients with bladder tumors, 3 patients with renal tumor, 2 patient with upper urinary tract tumor and 5 patients with prostatic hematuria were diagnosed. In the case of patients diagnosed with renal tumors and upper urinary tract, the diagnosis of suspicion was confirmed by performing CT.
Conclusions:
- It is a project in its beginnings so we have a small number of patients and we can not draw conclusions.
- With this consultation we hope to reduce the waiting time until the completion of the first visit, as well as the number of visits needed to complete the study.
- Performing an early diagnosis in patients with bladder cancer, decreasing the number of patients with muscle invasive bladder cancer.
- Reduction of the waiting list in a specialized care center, both in first-time appointment and in successive appointment.
Decrease in patient anxiety by making an early diagnosis of their pathology.
