Trushar Patel.

Objective To identify and describe the scientific evidence on Advanced Nursing Practice (ANP) in Urology. Methods Integrative literature review, guided by the guiding question: “What is the scientific evidence on advanced nursing practice in urology performed by nurses in health care?” The search was conducted in the following databases: PubMed, SciELO, CINAHL, Virtual Health Library (VHL), and Cochrane, covering the period from 2014 to 2024, in Portuguese, English, and Spanish. Results A total of 305 studies were identified, of which 10 comprised the final sample after applying the inclusion criteria. Most studies were in English, and the predominant methodological approach was descriptive (50%). The evidence highlighted the role of advanced practice nurses in promoting urinary health, managing urinary dysfunction and incontinence, and in the perioperative rehabilitation of urological patients. In addition, nurses played a significant role in education, prescribing conservative treatments, providing home guidance, and reducing waiting lists for specialized services, consolidating the importance of APN in urology. Conclusion ANP in urology has become extremely important for health care and promotion, improving patients’ quality of life. Nurses with the necessary skills care for individuals and combine this with problem-solving and autonomous practice. They are able to provide safe, high-quality care, promoting assistance, training, and guidance at home, in addition to developing patients’ self-care skills.

Spinal cord injury (SCI) leads to sensorimotor impairments; however, it can also be complicated by significant autonomic dysfunction, including cardiovascular and lower urinary tract (LUT) dysfunctions. Autonomic dysreflexia (AD) is a dangerous cardiovascular complication of SCI often overlooked by healthcare professionals. AD is characterized by a sudden increase in blood pressure (BP) that can result in severe cardiovascular and cerebrovascular complications. In this review, we provide an overview on the clinical manifestations, risk factors, underlying mechanisms, and current approaches in prevention and management of AD. After conducting a literature research, we summarized relevant information regarding the clinical and pathophysiological aspects in the context of urological clinical practice CONCLUSIONS: The most common triggers of AD are those arising from LUT, such as bladder distention and urinary tract infections. Furthermore, AD is commonly observed in individuals with SCI during urological procedures, including catheterization, cystoscopy and urodynamics. Although significant progress in the clinical assessment of AD has been made in recent decades, effective approaches for its prevention and treatment are currently lacking.

HF02-11 DR. CLYDE LEROY DEMING: VISIONARY DURING A TURBULENT TIME

Impact of the COVID-19 Pandemic on Urological Care Delivery in the United States.

Urine examination is one of the important armamentarium in the practice of urology and it is a fundamental test that is usually carried out for urology patients, it can be as simple as dipstick analysis to a complex hormonal assays. Urine examination is done worldwide as an extension of physical examination which provides a lot of information about the pathology, and both physical and chemical analysis of urine are highly informative. There are several types of urine investigations, some of which include urinalysis, urine microscopy culture and sensitivity, urine microscopy for ova or cyst of parasites, urine cytology, urine tumour antigens assays, urine hormonal assays, urine toxicology, urine quantitative measurement and urine acid fast bacilli. Uses of urine examinations in urology could be diagnostic, such as renal function test, evaluation of heamaturia, stone diseases, urinary tract infections, urologic cancers and infertility or monitoring and for prognosis. Uses of urine investigations in practice of urology cannot be over emphasized as it has many revealing information of the physiology and pathology of urologic organs.

Journal Article The practice of urology. By Leon Herman, B.S., M.D., Professor of Urology, University of Pennsylvania Graduate School of Medicine; Urologist to the Pennsylvania Hospital and to the Bryn Mawr Hospital; etc. 9 1/2 × 6 1/4 in. Pp. 923, with 504 illustrations. 1938. Philadelphia and London: W. B. Saunders Co. Ltd. 45s. net Get access The practice of urology. By LeonHerman, B.S., M.D., Professor of Urology, University of Pennsylvania Graduate School of Medicine; Urologist to the Pennsylvania Hospital and to the Bryn Mawr Hospital; etc. 9 1/2 × 6 1/4 in. Pp. 923, with 504 illustrations. 1938. Philadelphia and London: W. B. Saunders Co. Ltd. 45s. net British Journal of Surgery, Volume 26, Issue 103, January 1939, Pages 654–655, https://doi.org/10.1002/bjs.18002610327 Published: 06 December 2005

The Importance of Glucose-6-Phosphate Dehydrogenase Screening in a Urologic Practice

Use of Advanced Practice Providers to Improve Patient Access in Urology

PD13-03 ADVANCED PRACTICE PROVIDERS IN UROLOGIC CARE IN THE UNITED STATES

We examine changes in the volume of patients with advanced prostate cancer and prescriptions for abiraterone and enzalutamide among urology practices with and without in-office dispensing. Using data from the National Council for Prescription Drug Programs, we identified in-office dispensing by single-specialty urology practices from 2011 to 2018. As the greatest growth in implementing dispensing occurred among large groups in 2015, outcomes were measured at the practice level in 2014 (before) and 2016 (after) for dispensing and non-dispensing practices. Outcomes included the volume of men with advanced prostate cancer managed by a practice and prescriptions for abiraterone and/or enzalutamide. Using national Medicare data, generalized linear mixed models were fit to compare the practice-level ratio of each outcome (2016 relative to 2014) adjusting for regional contextual factors. In-office dispensing increased from 1% to 30% of single-specialty urology practices from 2011 to 2018, with 28 practices implementing dispensing in 2015. In 2016 compared to 2014, adjusted changes in the volume of patients with advanced prostate cancer managed by a practice were similar between non-dispensing (0.88, 95% CI 0.81-0.94) and dispensing (0.93, 95% CI 0.76-1.09) practices (P = .60). Prescriptions for abiraterone and/or enzalutamide increased in both non-dispensing (2.00, 95% CI 1.58-2.41) and dispensing (8.99, 95% CI 4.51-13.47) practices (P < .01). In-office dispensing is increasingly common in urology practices. This emerging model is not associated with changes in patient volume but is associated with increased prescriptions for abiraterone and enzalutamide.

SC179 - Urology practice during the COVID-19 vaccination campaign

Sonographers are key to providing optimal ultrasound imaging and patient care; however, they require guidance and training by both the more senior sonographers in the practice and by the practice physicians. The sonographer’s initial training and ongoing education are crucial for their growth and value to the practice. This chapter discusses the educational pathway and certification of the sonographer, as well as the essential role the sonographer plays in the urologic practice. Written by a registered diagnostic medical sonographer together with a physician ultrasound director of a large urologic practice, this chapter gives an insight into how to develop and maintain a partnership that will provide optimal ultrasound imaging and patient care.

Histopathological examination, a cornerstone in diagnosing cancer, faces challenges due to its time-consuming nature. This review explores the potential of ex-vivo fluorescent confocal microscopy (FCM) in urology, addressing the need for real-time pathological assessment, particularly in prostate cancer. This systematic review aims to assess the applications of FCM in urology, including its role in prostate cancer diagnosis, surgical margin assessment, and other urological fields. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search of PubMed and SCOPUS was conducted, focusing on English written original articles published after January 1, 2018, discussing the use of FCM in urological practice. The search included keywords related to FCM and urological terms. The risk of bias assessment was performed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A total of 17 relevant studies were included in the review that focuses on three main urological issues: prostate cancer (15 articles), bladder cancer (1 article), and renal biopsy (1 article). FCM exhibited significant promise in diagnosing prostate cancer. These studies reported an accuracy range of 85.33% to 95.1% in distinguishing between cancerous and non-cancerous prostate tissues. Moreover, FCM proved valuable for assessing surgical margins in real-time during radical prostatectomy, reducing the need for frozen section analysis. In some investigations, researchers explored the integration of artificial intelligence (AI) with FCM to automate diagnostic processes. Concerning bladder cancer, FCM played a beneficial role in evaluating urethral and ureteral margins during radical cystectomy. Notably, it showed substantial agreement with conventional histopathology and frozen section examination. In the context of renal biopsy, FCM demonstrated the potential to differentiate normal renal parenchyma from cancerous tissue, although the available evidence is limited in this area. The main limitation of the current study is the scarcity of data regarding the topic of interest. Ex-vivo FCM holds promise in urology, particularly in prostate cancer diagnosis and surgical margin assessment. Its real-time capabilities may reduce diagnostic delays and patient stress. However, most studies remain experimental, requiring further research to validate clinical utility.

Urinary tract infection is the most common disease in urological practice. The growth of antibiotic resistance in general and in urological practice in particular determines the need to develop methods for determining the risks of the presence of microflora resistance to antimicrobial drugs. The article discusses the existing methods for predicting the resistance of microorganisms to antibiotics, as well as the risk factor for antibiotic resistance developed by the author in community-acquired urinary tract infections. This indicator takes into account the individual characteristics and clinical and laboratory data of the patient with urinary tract infections that occur against the background of urolithiasis.

TRANSRECTAL ULTRASOUND OF THE PROSTATE: INNOVATIONS AND FUTURE APPLICATIONS