The proliferation of nurse-led initiatives arising from the rise in nurse specialist/practitioners and latterly consultant nurse posts, in primary and secondary care, is leading to a quiet revolution throughout the healthcare system in terms of not only service delivery, but also the nature and profile of the nursing profession. Within urology, nurses working at a level of higher practice may be engaged in the provision of nurse-led services that include intravesical chemotherapy for the treatment of bladder carcinoma, erectile dysfunction, stoma (urostomy) and bladder reconstructive surgery, continence and urodynamics services, research, pre-admission, clerking and assessment. One example of such an initiative is the nurse-led prostate assessment clinic; an innovation which has been developed throughout the United Kingdom to allow men with lower urinary tract symptoms thought secondary to benign prostatic enlargement, to be referred (by their general practitioner/family doctor) for comprehensive assessment, treatment and management. Consequently, many nurses working at this higher level of practice are being trained in the skills of physical examination and history-taking in order to recognise and determine abnormal clinical findings and report them to their medical colleagues, for example. Ultimately, nurse-led clinics provide an invaluable patient centred approach to the management of chronic disease which build upon skills such as counselling, teaching and health promotion which are the very cornerstone of contemporary nursing practice.
Clearly one thing which is being completely overlooked is the fact that men are being forced to accept female led procedures for intimate, personal, intrusive and embarrassing procedures. Many men choose NOT to proceed rather than accept this.