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ویرایش: 2
نویسندگان: Michelle Lajiness (editor). Susanne Quallich (editor)
سری:
ISBN (شابک) : 9783030452674, 3030452670
ناشر: Springer
سال نشر: 2020
تعداد صفحات: 552
زبان: English
فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود)
حجم فایل: 7 مگابایت
در صورت تبدیل فایل کتاب The Nurse Practitioner in Urology: A Manual for Nurse Practitioners, Physician Assistants and Allied Healthcare Providers به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
توجه داشته باشید کتاب پرستار پرستار در اورولوژی: راهنمای پرستاران، دستیاران پزشک و ارائه دهندگان مراقبت های بهداشتی وابسته نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
این نسخه جدید نسخه قبلی را به روز می کند و محتوای اضافی مربوط به مدیریت پس از عمل، مدیریت درد، مراقبت LGBTQ، و رادیولوژی ادراری را اضافه می کند. این کتاب برای پاسخگویی به نیازهای پرستاران، پرستاران حرفه ای پیشرفته در سطح جهان و دستیاران پزشک شاغل در اورولوژی طراحی شده است. محتوا برخی از دانش پیش زمینه را در مورد آناتومی و فیزیولوژی طبیعی سیستم ادراری تناسلی و پاتوفیزیولوژی زیربنایی مشکلات خاص مرتبط با سلامت اورولوژی را فرض می کند. این تضمین میکند که ارائهدهنده میتواند مدیریت نمونهای از بیماران مبتلا به شرایط حاد و مزمن اورولوژی را در طیف گستردهای از تنظیمات، از جمله شیوههای مستقل، و شیوههای اورولوژی دانشگاهی دنبال کند. این راهنما شکافهایی را که ممکن است برنامههای درسی سنتی ایجاد کرده باشد پر میکند و به خواننده این امکان را میدهد تا با اطمینان از مدیریت بیماران بزرگسال مبتلا به مراقبتهای اورولوژیک، نقش یک پزشک ماهر را در اورولوژی، به ویژه برای بیماریهای اورولوژی مزمن و غیرجراحی ارتقا دهد و در عین حال آنها را تشخیص دهد. شرایطی که ممکن است از مدیریت جراحی بهره مند شوند. با افزایش بار بیماری های اورولوژیک با افزایش سن جمعیت ایالات متحده، به طور فزاینده ای واضح است که پرستاران و دستیاران پزشک به سمت مراقبت از بیماران مبتلا به بیماری اورولوژی دعوت خواهند شد. استفاده از NPs و PAs در بالاترین سطح تحصیلات خود به یک استراتژی مهم برای حفظ دسترسی و کاهش هزینه ها تبدیل خواهد شد، در زمینه نیروی کار متخصص اورولوژی که در حال کاهش است. با این حال، موضوعات اورولوژی در برنامههای درسی NP و PA مورد توجه پراکنده قرار میگیرد و باعث میشود NPs و PA تمرینکننده با شکافهایی در دانش خود در مورد روندها و توصیههایی برای مدیریت شرایط سلامت اورولوژیک باقی بماند. با افزایش این تقاضا برای ویزیت ارائهدهنده برای نگرانیهای اورولوژی، تقاضا برای خدمات ارائهدهنده برای مراقبت از بیماران مبتلا به نگرانیهای سلامت اورولوژی نیز افزایش مییابد و فرصتی را برای NPs و PAs فراهم میکند تا به محیطهای تخصصی در اورولوژی منتقل شوند.
This new edition updates the previous one and adds additional content related to postoperative management, pain management, LGBTQ care, and uroradiology. This book is designed to meet the needs of nurse practitioners, advanced practice nurses globally and physician assistants working in urology. Content assumes some background knowledge regarding the normal anatomy and physiology of the genitourinary system and the pathophysiology underlying specific urologic health-related problems. This ensures that the provider can pursue exemplary management of patients with acute and chronic urologic conditions in a wide variety of settings, including independent practices, and academic urologic practices. This manual fills the gaps that traditional curricula may have left, permitting the reader to proceed with confident management of adult patients with urologic care needs, promoting the role of a skilled clinician in urology, especially for chronic, non-operative urologic conditions while recognizing those conditions which may benefit from surgical management.As the burden of urologic disease increases with an aging U.S. population, it is increasingly clear that nurse practitioners and physician assistants will be called on to move into roles caring for patients with urologic disease. Use of NPs and PAs to their highest education will become an increasingly important strategy for maintaining access and reducing costs, in the context of urologist workforce that is shrinking. However, urology topics receive sporadic attention in NP and PA curricula, leaving practicing NPs and PAs with gaps in their knowledge concerning trends and recommendations for management of urologic health conditions. As this demand for provider visits for urologic concerns increases, the demand for provider services to care for patients with urologic health concerns will also increase, and presents the opportunity for both NPs and PAs to move into specialty practice environments within urology.
Introduction Contents 1: Transitioning Pediatric Urology Patients (and Their Families) to Adult Urology Care Introduction Transitioning Discussion of Specific Pediatric Genitourinary Conditions Neurologic Conditions Obstructive Uropathy Bladder Exstrophy Disorders of Sexual Development Pediatric Urologic Cancer Survivors Congenital Kidney and Urinary Tract Anomalies Summary Resources for the Nurse Practitioner Resources for the Families References 2: Testosterone Deficiency Evaluation, Management, and Treatment Considerations Introduction Evaluation of Hypogonadism Testicular Failure (Primary Hypogonadism or Hypogonadotropic Hypogonadism) Hypothalamic-Pituitary Disruption (Secondary Hypogonadism) Infertility Testosterone Deficiency-Associated Comorbidities Hypogonadism and Cardiometabolic Syndrome Testosterone Deficiency and Diabetes Testosterone Deficiency, Obesity, and the Metabolic Syndrome Testosterone Deficiency and Opiates Other Clinical Conditions Testosterone Deficiency and Cancer Treatment HIV Testosterone Deficiency and Hepatitis C Osteopenia and Osteoporosis Diagnosis Treatment Intramuscular Injections Transdermal Patches Transdermal Gels and Solutions Buccal Tablets Subcutaneous Pellets Oral Testosterone Tablets or Capsules Contraindications and Precautions Monitoring Treatment Testosterone Deficiency and Prostate Cancer Societal Issues Conclusion Resources for Clinicians Resources for Patients References 3: Evaluation and Management of Common Scrotal Conditions Introduction Review of the Components of a Scrotal Exam Acute Scrotum (Acute Scrotal Pain) Overview History Testicular Torsion Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Management Surgical Options Preoperative Considerations Postoperative Management Complications/Risks Long-Term Considerations Torsion of the Testicular Appendage Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Management Epididymo-Orchitis Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Management Long-Term Management Testicular Descent Problems (Maldescensus) Cryptorchidism Overview Palpable Unpalpable Incidence Pertinent Anatomy and Physiology Signs and Symptoms Risk Factors Physical Exam Specific Maneuvers Diagnostic Tests Management Medical Surgical Long-Term Complications of Cryptorchidism Teaching Points Acute Idiopathic Scrotal Edema Overview Incidence History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Management Spermatocele Overview Incidence History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Management Surgical Options Postoperative Management Hydrocele Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Laboratory Imaging Studies Management Hematospermia Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Imaging Studies Procedures Management Testicular Microlithiasis Overview Incidence Pertinent Anatomy and Physiology History Signs and Symptoms Risk Factors Physical Exam Diagnostic Tests Management/Guidelines Varicocele Overview Incidence Pertinent Anatomy and Physiology Risk Factors History Signs and Symptoms Physical Exam Diagnostic Tests Management Treatment Options Radiologic Interventional Percutaneous Embolization Coil Embolization Balloon Embolization Varicocelectomy Criteria for Surgery Surgical Preoperative Considerations Postoperative Management Complications of Surgery Resources for the Nurse Practitioner Resources for the Patient References 4: Erectile Dysfunction: Identification, Assessment, Treatment, and Follow-Up Introduction Scope of the Problem Prevalence of Erectile Dysfunction and Aging Physiology of an Erection Etiology of Erectile Dysfunction Organic Etiologies of Erectile Dysfunction Risk Factors for Erectile Dysfunction Management of Erectile Dysfunction Identification of Erectile Dysfunction Assessment of Erectile Dysfunction Laboratory Evaluation Specialized Diagnostic Assessment Intervention and Treatment of Erectile Dysfunction First-Line Therapy Counseling Oral Agents Vacuum Constriction Devices Second-Line Therapy Intracavernosal Injection Therapy Intraurethral Therapy Third-Line Therapy Penile Implant Vascular Surgery Newer Experimental Treatments Penile Rehabilitation Follow-Up of Erectile Dysfunction Conclusion Resources for the Nurse Practitioner and Physician Assistant Resources for the Patient Sexual Health Inventory for Men (SHIM) Patient Instructions Over the Past 6 Months Scoring Key References 5: Benign Prostatic Hyperplasia Incidence and Epidemiology Pathophysiology Presentation History and Physical Examination Abnormal Findings Diagnostic Tests Management Surgical Management Resources for the Nurse Practitioner Resources for the Patient References 6: Hematuria Overview History Physical Examination Diagnostic Tests Laboratory Evaluation Imaging Studies Procedures Management Long-Term Management Resources for the Clinician Resources for the Patient References 7: Orchialgia and Urologic Chronic Pelvic Pain Syndromes in Men Overview and Introduction Acute Prostatitis Clinical Presentation Physical Examination Diagnosis/Evaluation Treatment Chronic Bacterial Prostatitis Clinical Presentation Physical Examination Diagnosis/Evaluation Treatment Follow-up Urologic Chronic Pelvic Pain Syndrome (UCPPS) Clinical Presentation Physical Examination Diagnosis/Evaluation Treatment Asymptomatic Inflammatory Prostatitis Clinical Presentation/Diagnosis Treatment Chronic Unexplained Orchialgia Background and Risk Factors Clinical Presentation and History Physical Examination and Diagnostic Testing Management Conclusions Resources for the Nurse Practitioner and Physician Assistant Resources for the Patient References 8: Kidney Stones Introduction Incidence Anatomy Risk Factors History Physical Examination Diagnostic Testing Laboratory Evaluation Imaging Management Surgical Management Postoperative Surgical Management Long-Term Management Resources for the Nurse Practitioner Resources for the Patient References 9: Idiopathic and Traumatic Male Urethral Strictures Overview Incidence Anatomy Etiology Symptoms Physical Exam Diagnostic Testing Management Postoperative Care Resources for the Nurse Practitioner and Physician Assistants Resources for the Patient References 10: Genitourinary Trauma General Principles Renal Trauma Overview Incidence Pertinent Anatomy and Physiology History/Common Presentation Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Management Nonsurgical Management Surgical Management Short-Term/Long-Term Complications Follow-Up Care Ureteral Trauma Overview Incidence Pertinent Anatomy and Physiology History/Common Presentation Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Management Surgical Management Short-Term/Long-Term Complications Follow-Up Care Bladder Injury Overview Incidence Pertinent Anatomy and Physiology History/Common Presentation Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Management Nonsurgical Management Surgical Management Short-Term/Long-Term Complications Follow-Up Urethral Trauma Overview Incidence Pertinent Anatomy and Physiology History/Common Presentation Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Management Nonsurgical Management Surgical Management Short-Term/Long-Term Complications Follow-Up External Male Genitalia Injury Overview Incidence Pertinent Anatomy and Physiology History/Common Presentation Physical Exam Diagnostic Tests Imaging Studies Management Nonsurgical Management Surgical Management Short-Term/Long-Term Complications Follow-Up Resources Resources for the Nurse Practitioner Resources for the Patient References 11: Diagnosis and Management of Urinary Tract Infections, Asymptomatic Bacteriuria and Pyelonephritis Diagnosis and Management of Urinary Tract Infections Definitions Incidence and Epidemiology Asymptomatic Bacteriuria Catheterized Urinary Tract Infections (CAUTI) Pathophysiology Classification Presentation History and Physical Examination Differential Diagnosis Diagnostic Testing Imaging Risk Factors Management of Urinary Tract Infections Behavioral Modifications Oral Supplements Pharmacological Treatment Recurrent Bacterial Cystitis Special Situations Pyelonephritis Incidence Presentation Classification Diagnostic Testing Complications Management References for Clinicians Resources for Patients Bibliography 12: Basics of Pre and Postoperative Management Specific to Urology Patients Introduction History Specifics Cardiac History and Examination Pulmonary History and Examination History and Examination Specifics for Patients with Diabetes History and Examination Specifics for Patients with Rheumatology Physical Examination Specifics for Patients Who Have a History of Previous Surgery Medication History Establishing Functional Capacity Preoperative Testing Electrocardiogram Laboratory Studies Chest X-ray Additional Cardiac Testing Anesthesia Assessment Cervical Spine Range of Motion Sleep Apnea American Society of Anesthesiologists Physical Status Classification System Venous Thromboembolism (VTE) Risk Stratification Patient Education for Optimizing Outcomes Diabetes Medication Management Anticoagulation Medication Management Additional Medication Management Lifestyle Modifications Postoperative Management Introduction Non-urological Surgery Post-op Retention (POUR) Introduction Incidence Diagnosis Management Resources for the Nurse Practitioner and Physician Assistant Resources for the Patient References 13: Neurogenic Bladder/Underactive Bladder Definition, Incidence, and Epidemiology Pathophysiology History Physical Examination Diagnostic Testing Urine Cytology Imaging Tests Endoscopic Assessment Urodynamic Tests Behavioral/Conservative Therapy Behavioral Treatment Incontinence Products Catheterization Intermittent Catheterization (IC) Versus Indwelling Intermittent Catheterization (IC) Pharmacology Surgical Care Sacral Nerve Stimulation Botulinum Toxin Preventing and Treating Infections Resources for the Patient Resources for the Nurse Practitioner References 14: Stress Incontinence Introduction Incidence Pertinent Anatomy, Physiology Pathophysiology History Diagnostic Evaluation Physical Exam Diagnostic Tests Management Conclusion Resources for the Nurse Practitioner Resources for the Patient References 15: Overactive Bladder Definitions Incidence and Epidemiology Risk Factors Guidelines for Treatment History and Physical Examination Female Examination Male Examination All Patients Diagnostic Testing Treatment for OAB: AUA Guidelines (Gormley et al. 2012) First-Line Therapy: Behavioral Management Second-Line Therapy: Medications General Comments Regarding Medications Third-Line Therapy: Neuromodulation and Botox Resources for the Nurse Practitioner Resources for the Patient References 16: Problems in Female Urology: Interstitial Cystitis/Bladder Pain Syndrome, Pelvic Floor Disorders, and Pelvic Organ Prolapse Overview IC/BPS Definitions Epidemiology Risk Factors Anatomy and Physiology History Physical Exam Specific Maneuvers Abnormal Findings Diagnostic Tests Laboratory Evaluation Imaging Studies Procedures Management Behavioral, Conservative, Complementary, and Alternative Medicine Pharmacotherapy Oral IC/BPS Medications Intravesical Instillations Neuromodulation Intradetrusor Botulinum Toxin Other Pain Injections Hyperbaric Oxygen Surgical Criteria for Surgery Preoperative Considerations and Additional Tests That May Be Appropriate Prior to Surgery Medications Teaching Points Postoperative Management and Short-Term Complications Long-Term Complications Pelvic Organ Prolapse and Pelvic Floor Disorders Definitions Epidemiology Anatomy and Physiology History Physical Exam Specific Maneuvers Abnormal Findings Diagnostic Tests Laboratory Evaluation Imaging Studies Procedures Management Behavioral, Conservative, Complementary and Alternative Medicine Medical Surgical Criteria for Surgery Preoperative Considerations and Additional Tests That May Be Appropriate Prior to Surgery Medications Teaching Points Postoperative Management Short-Term Complications Long-Term Complications Resources Resources for the Nurse Practitioner Resources for the Patient References Updated Citations 17: Diagnosis and Management of Localized Prostate Cancer Definitions Incidence and Epidemiology History/Presentation Risk Factors Physical Exam DRE Technique Diagnostic Testing Laboratory Studies Imaging Studies Procedures Procedure Management of Localized Prostate Cancer Surgery Resources for the Nurse Practitioner Resources for the Patient References 18: Bladder and Urothelial Cancer Overview Incidence Bladder Cancer Upper Tract Urothelial Cancer Urethral Cancer Pertinent Anatomy and Physiology Risk Factors History Physical Examination Diagnosis Staging of Urothelial Carcinoma Diagnostic Testing Laboratory Evaluation Diagnostic Studies Management of Urothelial Carcinoma Management of Urothelial Carcinoma of the Bladder Intravesical Immunotherapy and Chemotherapy Intravesical Immunotherapy Intravesical Chemotherapy Surgical Management Management of Urothelial Carcinoma of the Renal Pelvis and Ureter Management of Urothelial Carcinoma of the Urethra Preoperative Education Prior to Surgery for Urothelial Carcinoma Surveillance Recommendations for Urothelial Carcinoma Resources References 19: Kidney Cancer Overview Definitions Incidence Anatomy and Pathology Benign Renal Masses Cystic Renal Lesions History and Presentation Risk Factors Physical Exam Diagnostic Tests Laboratory Evaluation Imaging Studies Percutaneous Biopsy Management Surveillance of Renal Masses Surgical Intervention Radical Nephrectomy Partial Nephrectomy Thermal Ablation Follow-Up Resources for the Nurse Practitioner Resources for the Patient References 20: Neoplasms of the Penile and Testis Penile Neoplasms Epidemiology and Risk Factors Clinical Diagnosis and Staging History and Physical Examination Diagnostic Tests Management Perioperative Management Long-Term Follow-Up Testis Neoplasms Epidemiology and Risk Factors Anatomy Clinical Diagnosis and Staging History and Physical Examination Diagnostic Tests Management Perioperative Management Long-Term Management Cultural Considerations with Penile and Testicular Neoplasms Resources for the Nurse Practitioner Resources for the Patient References 21: Radiology in Urologic Patients Plain Abdominal X-ray (KUB) Indications Patient Preparation Contraindications Basic Equipment and Techniques Intravenous Urogram (IVU) Indications Proper Preparation Includes Contraindications Complications Retrograde Urogram (Retrograde Pyelogram, RP) Indications Patient Preparation Contraindications Complications Antegrade Pyelography Patient Preparation Indications Contraindications Complications Voiding Cystourethrogram (VCUG) Indications Patient Preparation Contraindications Complications Retrograde Urethrogram (RUG) Indications Patient Preparation Contraindications Complications Renal Nuclear Scan (Radionuclide Imaging) Indications Patient Preparation Contraindications Complications Angiography Indications (Bishoff and Art 2016) Complications Contraindication Ultrasonography (US) Patient Preparation Indications Kidneys Urinary Bladder Prostate Scrotum (Ramchandani 2014) Genital Evaluation Complications Contraindications Computed Tomography (CT) Scan Patient Preparation Indications Complications Magnetic Resonance Imaging (MRI) Patient Preparation Indications (Ramchandani 2014) Contraindications Complications Contrast Materials Contraindications Complications Contrast-Induced Nephrotoxicity Adverse Reactions to Contrast Material Preparation of Patients with Contrast Allergy (Bishoff and Art 2016) Cautions in Using Contrast Material Should Be Exercised in These Patients Radiation Safety References 22: Procedures for the Nurse Practitioner in Urology Introduction Objectives Urethral Dilation Define Procedure Indications Prep Required Pre-procedure Considerations Post-procedure Instructions to Call Clinic Follow-up Discussion Referral Suggestions Insurance Issues Guidelines Option for Difficult Urinary Catheterization Resources for Learning AUA Core Curriculum Available at Auanet.org with Membership CME Review Article National and Local Meeting Courses Book Chapters General Urethral Stricture Management Journal Articles on Local Anesthetic Use Cystoscopy Define the Procedure Indications Prep Required Pre-procedure Considerations Discussion/Pearls of Cystoscopy Post-procedure Instructions/Red Flags Referral Suggestions Resources for Learning and Suggested Reading National and Local Meeting Courses Guidelines AUA Core Curriculum Available at Auanet.org with Membership Book Chapters Local Anesthetic Use and Discomfort Antibiotic Prophylaxis Role of APP in Cystoscopy Artificial Urinary Drainage and Surveillance Complications Testopel® (Testosterone Pellets) Define the Procedure Indications Contraindications Warnings/May Cause Site Reactions Patient Prep Post-procedure Instructions/Red Flags Discussion Referral Insurance Billing Codes Resources Training Videos Seminars Patient Satisfaction Dosing Complications Book Chapters Vantas® (Histrelin Acetate) Define the Procedure Indications Contraindications Warnings/May Cause Patient Prep Post-procedure Instructions/Red Flags Insurance/Coding Discussion Cultural/Religious Considerations Referrals Resources and References Websites Dose Efficacy Tolerability Patient Safety Book Chapter Other Suggested Readings Seminars Penile Nerve Block Define the Procedure Indications Pre-procedure Preparation Post Dorsal Penile Block Complications Follow-up Insurance Coverage Resources Online Videos Guidelines Book Chapters Journal Articles on Penile Nerve Block Online Resources References Reduction of Paraphimosis Define the Procedure Indications Procedure Pre-procedure Preparation Post-procedure Instruction Follow-up Insurance Coverage Resources Online Videos Guidelines Book Chapters Journal Articles on Paraphimosis Reduction Online Resources Paraphimosis References Penile Duplex Doppler Ultrasound Description of Procedure Indications Pre-procedure Preparation Post-procedure Instruction Follow-up Insurance Coverage Resources National and Local Meeting Courses Online Videos Book Chapters Journal Articles on Penile Duplex Doppler Ultrasound Online Resources Guidelines Penile Duplex Doppler Ultrasound References Xiaflex® (Collagenase Clostridium Histolyticum) Injections Description of Procedure Indications Pre-procedure Preparation Post-procedure Instruction/Red Flags Follow-up Insurance Coverage Resources Online Videos Book Chapters Journal Articles on Penile Duplex Doppler Ultrasound Online Resources Guidelines Collagenase Clostridium Histolyticum (Xiaflex) Injections References Transrectal Ultrasound (TRUS)-Guided Prostate Needle Biopsy Description of Procedure Indications Pre-procedure Preparation Post-procedure Complications Follow-up Insurance Coverage Resources Online Videos National and Local Meeting Courses Book Chapters Journal Articles on TRUS and Prostate Biopsy Journal Articles on Ultrasound of the Prostate Online Resources Guidelines AUA/SUNA White Papers TRUS Prostate Biopsy Resources References Further Reading 23: Pain Management and the Urology Patient Introduction Incidence Pathophysiology of Pain and Types of Pain Assessment of Pain Patient Pain History Physical Exam Laboratory and Imaging Studies Comorbid Conditions that Impact Acute and Chronic Pain Postsurgical Pain Management Chronic Postsurgical Pain (CPSP) Anticipating Chronic Postsurgical Pain Barriers to Effective Pain Management Resources for Nurse Practitioners and Physician Assistants Resources for Patients References 24: LGBTQ Cultural Humility for the Urology Healthcare Provider Introduction About Terms and Language Existing State of LGBTQ Healthcare Healthcare Providers and Access to Care Disclosure of Sexual Orientation and Gender Identity to Healthcare Providers Health Disparities Minority Stress Theory Oppression and Discrimination Cultural Humility Providing Inclusive and Affirming Care Cultural Humility: Self-reflection Education Creating Safe Spaces Urology-Specific Considerations for LGBTQ Patients Health Promotion and Disease Prevention Obesity Tobacco Use Prostate Cancer Screening Sexual History Sexual Function and Satisfaction Anal Intercourse Screening for STIs, Including HIV Family Planning Sexual Functioning Erectile Dysfunction Premature Ejaculation Decline in Sexual Desire Sexual Dysfunction, HIV, and AIDS Lower Urinary Tract Symptoms (LUTS) Prostate Cancer Care: Special Considerations Urology and Transgender Men and Women Access to Bathrooms Tucking Packing Fertility Preservation for Transgender Individuals Gender Affirming Surgeries and Urologic Complications Transgender Women (Male to Female Surgeries): Feminizing Genitoplasty Transgender Men (Female to Male Surgeries): Masculinizing Genitoplasty Urological Physical Examination Gender Affirmation Surgery Summary Urology for Intersex Individuals Summary and Clinical Pearls References 25: The Medical/Nursing Expert Witness: A Primer and Considerations for the Practitioner and the Profession Introduction The Nurse Practitioner or Physician Assistant Expert Witness: Considerations and Discussion I. The Expert Witness II. What Are the Relevant Rules and Regulations for Medical Experts III. How to Qualify as a Medical Expert IV. What Is Expected of a Medical Expert? IV. What Standard Is Used by the Expert in Evaluating the Medical Care V. WHAT ARE the Challenges and Potential Perils of Being a Medical Expert? VI. How to Substantially Mitigate Professional Risk as an Expert VII. What Are the Opportunities/Challenges for the Profession? Listing of Sources 26: Special Topics for the Advanced Practice Provider in Urology Urologic Complications of Genital Gender Confirmation Surgery Introduction Evaluation and Management of Complications Following Feminizing Genitoplasty Urinary Complications Neovaginal Stenosis Rectovaginal Fistula Evaluation and Management of Complications Following Masculinizing Genitoplasty Urethrocutaneous Fistula Urethral Stricture Remnant Vaginal Cavity Executive Summary: Competencies for the Nurse Practitioner Working with Adult Urology Patients Original Reference Introduction Background Role and Scope of the Advance Practice Urology Nurse Theoretical Framework Overview of and Limitations of the Competencies Summary Male Fertility Overview Barriers to Care When to Refer History and Physical Examination Management Behavioral and Conservative Management Medical Management Surgical Management Long-Term Follow-Up Resources for the Nurse Practitioner or Physician Assistant Resources for the Patient What Is Men’s Health? Health Disparity and Social Determinants of Health Gender and Men’s Health Behaviors Healthcare Providers Attitudes Toward Men’s Health Men’s Health Reports Changing Attitudes and Perceptions of Men’s Health The Scope and Challenge of Men’s Health Advanced Practice Providers in Men’s Health The Future of Men’s Health Vasectomy and Male Birth Control Consultation and Evaluation Follow-Up Male Birth Control Inflammatory Conditions of the Penis and Urgent Urology Conditions (Tables 26.4 and 26.5) References