105HO: Introduction to Office-Based Transperineal Prostate Interventions: Systematic Biopsy, RectalHydrogel Spacer and MR/US Fusion - Session 1 of 2

Saturday, September 11, 2021

7:30 AM – 10:00 AM

Course Director(s)

Arvin George, MD

University of Michigan
John Thomas Wei, MD

Professor
University of Michigan

Faculty(s)

Abhinav Sidana, MD,MPH

University of Cincinnati College of Medicine
Lindsey Allison Herrel, MD

University of Michigan

Proctor(s)

Timothy K. Byler, MD

Associate Professor of Urology
SUNY Upstate Medical University, Department of Urology, Syracuse, NY 13200
Michael A. Gorin, MD

Staff Urologist, Urology Associates & UPMC Western Maryland
University of Pittsburgh School of Medicine
Richard Julius Szabo, MD

CEO and Founder
Department of Urology, University of California, Irvine
John M. Dibianco, MD

The University of Michigan
AP

Amit K. Patel, MD

Henry Ford Hospital
Paul Daniel Maroni, MD

University of Colorado
JW

James S. Wysock, MD

NYU Langone Health
Amin S. Herati, MD

Johns Hopkins

Participants should be aware of the following financial/non-financial relationships:

Arvin George, MD: Disclosure information not submitted.

John Thomas Wei, MD: Disclosure information not submitted.

Abhinav Sidana, MD,MPH: Disclosure information not submitted.

Lindsey Allison Herrel, MD: Disclosure information not submitted.

Timothy K. Byler, MD: Disclosure information not submitted.

Michael A. Gorin, MD: Disclosure information not submitted.

Richard Julius Szabo, MD: Disclosure information not submitted.

John M. Dibianco, MD: Disclosure information not submitted.

Amit K. Patel, MD: Disclosure information not submitted.

Paul Daniel Maroni, MD: Disclosure information not submitted.

James S. Wysock, MD: Disclosure information not submitted.

Amin S. Herati, MD: Disclosure information not submitted.

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.

There will be two hands-on sessions offered during the course time. Registrants will be assigned to a session based on demand and notified of their session by August 23, 2021.

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AUA reserves the right to cancel any AUA2021 Hands-on Skills Trainings for any reason before August 16, 2021. In particular, our ability to offer these activities is contingent upon offering them safely for registrants, faculty, staff, and equipment providers in light of the evolving COVID-19 environment. If you have registered for an AUA2021 Hands-on Skills Training and it is subsequently canceled by AUA, you will be eligible for a full refund of that registration fee. If AUA cancels a Skills Training, notification will be sent to registered attendees by August 23, 2021.

Learning Objectives:

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.
Assemble the transperineal access device, demonstrate transperineal access to any location in the prostate for biopsy and markers and perform biopsy.
Identify the available transperineal fusion biopsy platforms and mechanisms of co-registration and perform co-registration and targeted sampling using one of these platforms.
Cite the outcomes and limitations of transperineal rectal hydrogel spacer placement, construct a rectal hydrogel spacer kit, and demonstrate safe placement of hydrogel spacer from start to finish.