(158) UTILITY OF PRIMARY CARE PHYSICIANS IN A UROLOGY MEN’S HEALTH CLINIC

Abstract Introduction Urology clinics may receive consultation referrals for clinical issues which do not require surgical specialist management. Additionally, with ongoing expansion of therapeutic options in men’s health, referring family medicine physicians may not be aware of all potential treatment modalities. Delayed time from referral to specialist consultation represents a significant issue in Canadian healthcare. Common referrals from general practice for urology assessment includes erectile dysfunction and testosterone deficiency. Multidisciplinary clinics enable access to care for various men’s health concerns where some may not require urologic surgeon specialist intervention. Objective We aim to assess whether men’s health trained primary care providers (PCPs) with foundational training in men’s health working within a multidisciplinary clinic can address common urologic referrals and reduce the need for specialist management of urology clinic referrals. Methods A retrospective chart review was performed involving all patients referred by personal primary care providers to urology who were screened by a urologist as appropriate for initial consultation by a PCP at a multidisciplinary men’s health clinic from January 2022 to January 2023 in Winnipeg, Canada. Patient demographics, medical concern, management, time from referral to treatment, and need for urologist follow-up was captured. There were no inclusion or exclusion criteria. Results A total of 419 patients were identified. Treatment data for all were collected. 331 patients (79%) were managed by an in-house PCP alone and 88 (21%) required urologist consultation following PCP assessment. De novo erectile dysfunction, low testosterone and orchalgia were the most common issues triaged to PCP initial management. Issues managed by PCP also included penile curvature, functional sexual concerns and lower urinary tract symptoms. Male infertility, penile curvature, and orchalgia were the most prevalent conditions requiring subsequent urologist referral. PCPs were able to initiate non-surgical therapies in a majority of patients. In analysis of treatment by primary referral medical concern, 100% of low testosterone, 96% of erectile dysfunction, and 82% of orchalgia were managed at the PCP level alone and did not require urologic surgeon assessment. Conclusions PCPs in a multidisciplinary clinic can provide care for a range of urologic issues and reduce need for urologist consultation. This study demonstrates the utility of PCPs in optimization of urologist consultation. Presenting issues may be predictive of the need for urologist referral. Disclosure No.

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