Risk factors for the delay in the diagnosis of penile lesions: results from a single center in Italy

September 2018

Minerva urologica e nefrologica = The Italian journal of urology and nephrology 71(3)

DOI:10.23736/S0393-2249.18.03189-2

Authors

Aldo F De Rose, Guglielmo Mantica, Fabio Gallo, Federico Dotta, Nicolò Testino, Andre van der Merwe, Carlo Terrone

Abstract

Background: Early diagnosis is fundamental for the investigation and treatment of penile lesions. There is an unfortunate documented delayed in presentation and diagnosis of penile lesions. Literature is scant regarding the risk factors contributing to this delay in a Mediterranean population. Few previous reports are published in entirely different homogeneous populations. The objective of this study is to provide an analysis of the causes and risk factors related to the delay of the first medical visit in a North Italian population subgroup. Methods: From September 2004 to September 2017, 184 consecutive patients were treated at our institute with a surgical approach for a penile lesion. The epidemiological factors and reasons for the delay to diagnosis were recorded during personal or telephonic interviews. Univariate logistic regression models were performed to screen for an effect of the clinical and demographic variables on the delay in diagnosis. Variables with a p-value of less than 0.05 were entered into multivariate analysis, where the delay in diagnosis was the dependent variable. Results: One hundred and thirteen patients were enrolled. The average patient age was fifty-eight. The average delay between the appearance of the lesion and the first medical consultation was fifty- three days. The principal cause of delay was the lack of knowledge of penile lesions and secondly, the feeling of embarrassment of having to visit a doctor. The multivariate analysis reported a significant correlation between the level of education, sexual activity and extramarital affairs on the delay in presentation (p-values respectively: 0.01, 0.009 and 0.04). Conclusions: Patients education regarding this pathology and its potential danger is inadequate and thus it is necessary to implement a campaign of information and prevention in order to reduce delayed diagnosis.