Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy Under Local Anesthesia.

Autor: Bulusu A; Department of Urology, University of Michigan, Ann Arbor, MI., Ferrante S; Department of Urology, University of Michigan, Ann Arbor, MI., Wu RC; Department of Urology, E-Da Hospital, Kaoshiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan., Qi J; Department of Urology, University of Michigan, Ann Arbor, MI., Montie J; Department of Urology, University of Michigan, Ann Arbor, MI., Ginsburg KB; Department of Urology, Wayne State University, Detroit, MI., Semerjian A; Department of Urology, University of Michigan, Ann Arbor, MI; IHA Urology, Ypsilanti, MI., Raman JD; Department of Urology, Penn State Health, Hershey, PA., Ginzburg S; Einstein Medical Center Philadelphia, Philadelphia, PA., Patel A; Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI., Rogers CG; Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI., George VK; Michigan Institute of Urology, Troy, MI., Stork B; Department of Urology, University of Michigan, Ann Arbor, MI., George AK; Department of Urology, University of Michigan, Ann Arbor, MI; Brady Urological Institute, Johns Hopkins University, Baltimore, MD. Electronic address: arvinkgeorge@gmail.com.
Jazyk: angličtina
Zdroj: Urology [Urology] 2024 Sep; Vol. 191, pp. 12-18. Date of Electronic Publication: 2024 Apr 26.
DOI: 10.1016/j.urology.2024.04.019
Abstrakt: Objective: To assess perceptions, practice patterns, and barriers to adoption of transperineal prostate biopsy (TPBx) under local anesthesia.
Methods: Providers from Michigan urological surgery improvement collaborative (MUSIC) and Pennsylvania urologic regional collaborative (PURC) were administered an online survey to assess beliefs and educational needs regarding TPBx. Providers were divided into those who performed or did not perform TPBx. The MUSIC and PURC registries were queried to assess TPBx utilization. Descriptive analytics and bivariate analysis determined associations between provider/practice demographics and attitudes.
Results: Since 2019, TPBx adoption has increased more than 2-fold to 7.0% and 16% across MUSIC and PURC practices, respectively. Of 350 urologists invited to participate in a survey, a total of 91 complete responses were obtained with 21 respondents (23%) reported performing TPBx. Participants estimated the learning curve was <10 procedure for TPBx performers and non-performers. No significant association was observed between learning curve and provider age/practice setting. The major perceived benefits of TPBx were decreased risk of sepsis, improved cancer detection rate and antibiotic stewardship. The most commonly cited challenges to implementation included access to equipment and patient experience. Urologists performing TPBx reported learning curve as an additional barrier, while those not performing TPBx reported duration of procedure.
Conclusion: Access to equipment and patient experience concerns remain substantial barriers to adoption of TPBx. Dissemination of techniques utilizing existing equipment and optimization of local anesthetic protocols for TPBx may help facilitate the continued adoption of TPBx.
Competing Interests: Declaration of Competing Interest Brian Stork stock holder for Greater Michigan Lithotripsy, Muskegon Surgery Center, Theralogix IV, Michigan Mobile Urology Services and partner in MED5 (StomaCloak). Craig Rogers salary support from Blue Cross Blue Shield of Michigan. Jay Raman stock holder for American Kidney Stone Management and United Medical Systems, Inc. Study investigator funded by Urogen Pharma, Pacific Edge Biotechnologies, and Steba Biotech. Jim Montie salary support from Blue Cross Blue Shield of Michigan. Kevin Ginsburg salary support from Blue Cross Blue Shield of Michigan. Serge Ginzburg, Richard Wu no conflict. Alice Semerjian salary support from Blue Cross Blue Shield of Michigan. Amit Patel payment from CIVCO. Asha Bulusu, Ji Qi, Stephanie Ferrante, Valal K. George no conflict. Arvin K. George salary support from Blue Cross Blue Shield of Michigan, paid consultant to Sonablate Corporation, HIFU Prostate Services, CIVCO, and Boston Scientific. Payment from bK Medical and McConnel Van Pelt. Boar membership with Lina Medical, Focal Therapy Society Board of Directors, and UroMedEd Corporation. Investigator funded by Angiodynamics.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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