Evaluating the distance travelled for urological pediatric appointments

In Quebec, eight pediatric urologists practice in three tertiary centers covering large territories. To improve the availability of pediatric urology to distant families and to reduce the economic burden on them, we examined the charts of all patients attending the pediatric urological outpatient clinic. Our objectives were to evaluate the distance travelled by each urological pediatric outpatient and to report the most frequent urological referral complaints.

From July 2016 to June 2017, we retrospectively reviewed the charts of all the 3604 pediatric patients seen in the outpatient urological clinic of the CHU de Québec. We specifically focused on travel distance covered by families and the reason for referral.

Most patients were boys (78%) and the mean age was 7.2 years. The average one-way distance travelled by each family was 69 km. The patients came more frequently from Capitale-Nationale (63.7%) and Chaudière-Appalaches (21.9%), the closest regions. The most common reasons for consultations were postoperative followups (15%), phimosis and adhesions (14%), enuresias (14%), hydronephrosis (13%), micturition disorder (11%), and cryptorchidism and retractile testicles (8%). Of all patients seen for phimosis or cryptorchidism, only 24% and 36% of them, respectively, were scheduled for surgery.

Phimosis, cryptorchidism, and voiding disorders are the most frequent pediatric urological reasons for consultation; primary care continuing medical education seems worthwhile. It would, perhaps, be more beneficial for all to have the pediatric urologists travelling to perform clinics and surgeries in distant regions to save more than 300 km round trip to several families.