Anna Myers, CNP, on the overlap between urological and gynecological conditions

In a recent interview with Urology Times®, Anna Myers, CNP, a certified nurse practitioner with University Hospitals in Cleveland, Ohio, was asked how she approaches differential diagnosis, given the overlap between urological and gynecological conditions in her patient population.

“When patients come to me and they fill out their intake form, along with asking about pelvic pain and overactive bladder symptoms and urinary tract infections and that sort of thing, I have a screening tool called the Decreased Sexual Desire Screener, and it's just a simple, short screening tool,” Myers explains.

The first 4 questions, she said, help to determine whether a patient has decreased desire.

“A lot of times…decreased desire is affected by everything else: pain with sex, orgasm, arousal. Because if none of that is good, then desire isn't going to be good either,” Myers said.

The fifth question, Myers said, “details the different issues that could be [happening]. Oftentimes women, they know what's going on. Is it a relationship thing? Is it a hormonal thing?”

Myers also talked about obtaining a thorough history from patients, where we just sit and we listen to our patients, we try to not talk, and we just try to let them tell us what's going on.”

Myers discussed the physical exam as well.

“If it's pain with insertion, I do my exam, I really get into the details with a Q tip. I lightly touch them on their vulva, and I find out, is this pain more in the vestibule area? Is this hormonal related? Is it related to nerves? Is it related to infections that they've been having? Is it related to a skin condition, [such as] lichen sclerosis?”