In this episode of The Expert Approach: Conversations in Uro-Oncology, host Joy Maulik, CRNP, speaks with J. Brandon Arruda, APRN, AGNP-C, CUNP, a urologic oncology nurse practitioner at WVU Medicine, about the evolving role of advanced practice providers (APPs) in urology. Arruda, who also directs the WVU Urology APP fellowship and serves in multiple leadership and educational capacities, shares insights into clinical practice, fello Arruda recalls how he came to urology “by accident” but has remained in the field for over a decade due to the specialty’s culture of collaboration and strong support for APPs. He highlights the success of WVU’s pilot urology fellowship program, which launched in 2024 to address provider shortages in West Virginia. The program’s goal is to “train to retain” APPs in the region by combining structured didactics with hands-on rotations in general urology, pediatrics, and urologic oncology. Clinically, Arruda performs a wide range of procedures, including cystoscopies, BCG instillations, intravesical chemotherapy, stent removals, and diagnostic evaluations for hematuria. He emphasizes the importance of APPs being procedurally proficient, particularly as innovations in bladder cancer therapies—such as the gemcitabine intravesical system Inlexzo (formerly TAR-200) and novel intravesical agents—expand treatment options. For hematuria workups, Arruda stresses guideline-based risk stratification, careful history-taking, and patient reassurance through cystoscopy when appropriate. Beyond the bedside, Arruda underscores the strategic value of APPs in leadership roles. As health systems shift toward value-based care, he sees APPs as uniquely positioned to lead disease-specific care pathways, enhance procedural efficiency, and strengthen team-based models. He encourages organizations to “sprinkle the salt where it’s needed most,” recognizing APPs as integral to work force sustainability and patient-centered care. Chapters 5:52 What makes you stay in urology? 11:48 WVU APP fellowship program 22:17 Arruda on procedures he performs 27:01 Evaluation of hematuria 33:38 Alternatives to BCG in bladder cancer 41:10 APPs as part of the leadership team

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