Hands-On Courses - Additional Registration Fee Required

(SOLD OUT) 104HO: Introduction to Office-Based Transperineal Prostate Interventions: Systematic biopsy, Rectal Hydrogel Spacer, and MR/US Fusion

Co-Course Director(s)

• 

  Arvin George, MD

  University of Michigan
• 

  John Wei, MD

  Professor
  University of Michigan

Faculty(s)

• 

  Chandy Ellimoottil, MD

  University of Michigan
• 

  Lindsey Herrel, MD

  University of Michigan
• 

  Art Rastinehad, DO

  Icahn School of Medicine at Mount Sinai

Proctor(s)

• 

  John Dibianco, MD

  The George Washington University School of Medicine
• VG

  Valal George, MD,PHD
• 

  Jim Hu, MD,MPH

  Weill Cornell Medicine
• 

  Peter Pinto, MD

  National Cancer Institute, National Institutes of Health
• 

  Richard Popert, MD

  Guy's & St Thomas NHS Foundation Trust
• JT

  James Tierney, MD

  Charleston Area Medical Center
• 

  Osamu Ukimura, MD

  Professor and Chairman
  Kyoto Prefectural University of Medicine
• 

  Bradford Wood, MD

  NIH
• JW

  James Wysock, MD

  NYU School of Medicine

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.

A novel device 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 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 provide 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. We will critically evaluate the evidence supporting transperineal biopsy with regards to cancer detection, biopsy-related complications, and patient experience. Additionally, we will review the evidence for hydrogel spacer as it relates to patient-reported outcomes during radiation therapy.

During the hands-on portion of the course, we will cover techniques for systematic transperineal biopsy, transperineal MR/US fusion-guided prostate biopsy platforms, and fiducial marker/hydrogel spacer placement. Transperineal biopsy procedures will be performed on ‘realistic’ anthropomorphic phantoms while hydrogel spacer placement experience will be obtained with a computer simulator.

At the conclusion of this course, the urologist will be able to counsel a patient and demonstrate the skills needed to perform in-office transperineal prostate procedures under local anesthesia.

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 3.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Learning Objectives:

• Describe the shortcomings of transrectal biopsy including the risk of infectious and bleeding complications, and the rising risk of antibiotic resistance.
• List the indications, contraindications and limitations of transperineal prostate access.
• Describe 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.
• Conduct transperineal prostate block (local anesthesia) independently.
• Demonstrate the technique for transperineal prostate biopsy both freehand and with the PrecisionPoint access system.
• Define the indication for MR/US fusion biopsy.
• List the steps of fusion biopsy including MR acquisition, prostate and lesion segmentation, co-registration, and sampling and demonstrate the technique for transperineal fusion biopsy with at least one commercially available platform.
• Conduct freehand transperineal placement of fiducial markers independently and list the steps for placement of transperineal hydrogel spacers.
• Demonstrate the techniques for transperineal placement of hydrogel spacers.