List the indications, contraindications, and limitation of transperineal prostate access.
Describe the shortcomings of transrectal biopsy including the risk of infectious and bleeding complications, and the rising risk of antibiotic resistance.
Discuss the equipment required and setup for office-based transperineal procedures under local anesthesia.
Describe outcomes of patients undergoing transperineal systematic prostate biopsy including cancer detection rate, complications, and patient experience.
Demonstrate transperineal peri-prostatic block and assemble the transperineal access device, demonstrate transperineal access to any location in the prostate for biopsy and markers and perform biopsy.
Transrectal prostate biopsy has a cemented role in the diagnosis of prostate cancer, however there is mounting concern regarding biopsy-related infectious complications. Transperineal access to the prostate offers an opportunity to completely avoid fecal contamination during biopsy and significantly reduce complications inherent to transrectal sampling.
Novel devices and updated sampling techniques have recently been introduced to allow for in-office transperineal biopsy performed under local anesthesia. Such advances permit urologists to perform a transperineal biopsy, historically performed under general anesthesia, in the same amount of time and with significantly less side effects.
Proficiency in transperineal prostate access has also enabled the administration of hydrogel spacers and placement of fiducial markers. The creation of a safety zone between the prostate and rectum minimizes its exposure to radiation, significantly limiting bowel toxicity.
Following landmark trials demonstrating the value of prostate MRI and targeted sampling, adoption continues to rise and with it the development of transperineal platforms to support both biopsy and treatment.
It is essential that urologists understand the basic fundamentals of office-based transperineal access to the prostate. The goal of this beginner course is to produce a hands-on experience that provides an introduction to these novel technologies and the skills needed to perform transperineal interventions under local anesthesia.
Participants will have the opportunity to ask questions and obtain tips and tricks from some of the leaders in the field who have helped develop these new technologies and techniques.
Accreditation: The American Urological Association (AUA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit Designation: The American Urological Association designates this live activity for a maximum of 3 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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