Performing sensitive clinical examinations during urological telemedicine visits: how to avoid pitfalls?

Abstract

Background and aims: The impact of coronavirus disease 2019 presented an unprecedented challenge to urological service globally. In many countries, outpatient clinics were cancelled, and the use of telemedicine visits was increased. For urological complaints, the need to perform a sensitive clinical examination via telemedicine posed an unfamiliar environment. Our aim is to explore the clinical and ethical factors involved in performing remote sensitive clinical examinations.

Methods: A comprehensive review of literature and guidance from various medical bodies internationally was conducted using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar, and Research Gate in the first week of March 2021 including "COVID-19," "telemedicine," "urology," and "sensitive examinations."

Results: Telemedicine reduced unnecessary visits to medical facilities and was useful for reducing the risk of transmission during the COVID-19 pandemic. We propose that in order to perform a sensitive clinical examination via telemedicine, the following four steps must be considered: assessment of the clinical need, obtaining informed consent, use of a chaperone, and thorough documentation.

Conclusion: Telemedicine will play a pivotal role in the future of urological practice beyond this present pandemic. However, sensitive clinical examinations using such technology must be performed in appropriate settings and situations. Suitable training, enhanced documentation, communication, and observing information governance guidance will aid in avoiding clinical and ethical pitfalls.