MP80-01 TRANSPERINEAL PROCEDURES (BIOPSY AND CRYOABLATION) UNDER LOCAL ANESTHESIA: OUR EXPERIENCE AFTER 1,015 PROCEDURES

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2018MP80-01 TRANSPERINEAL PROCEDURES (BIOPSY AND CRYOABLATION) UNDER LOCAL ANESTHESIA: OUR EXPERIENCE AFTER 1,015 PROCEDURES Fernando Bianco, Jose Antonio Grandez, Sergio Lozano-Kaplun, Marilin Nicholson, Ariel Kaufman, and Gloria Egui-Benatouil Fernando BiancoFernando Bianco More articles by this author , Jose Antonio GrandezJose Antonio Grandez More articles by this author , Sergio Lozano-KaplunSergio Lozano-Kaplun More articles by this author , Marilin NicholsonMarilin Nicholson More articles by this author , Ariel KaufmanAriel Kaufman More articles by this author , and Gloria Egui-BenatouilGloria Egui-Benatouil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2689AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The perineal area has been evasive to office based approaches given its sensitivity, difficult access requiring lithotomy or exacerbated lithotomy positioning. Indeed, general or spinal anesthesia is commonly required for a prostate biopsy if performed thru the perineum. The emergence of MRI-Ultrasound (MR/US) fusion biopsies has led to an increased precision in the diagnosis of prostate cancer. However, this fusion technology is mostly implemented using the transrectal technique. Herein, we present our method to block the perineum making it feasible to perform procedures (Prostate Biopsy and Cryoablation) safely in the office setting under local anesthesia METHODS This study evaluated consecutive men who presented to our office for a transperineal procedure, either MR/US Fusion Biopsy or Cryoablation performed using a novel perineal block. The procedures were performed between August 2014 and September 2017. The information was collected prospectively using the Focalyx App (ISO, Android). For this report we queried diagnostic and treatment information such as: age, PSA, DRE findings, clinical stage, WHO Modified Gleason scores, co-morbidities, biopsy and treatment duration, Pain - measured with wonker baker pain faces scale - and clavien-dindo system 30 day outcomes post procedure outcomes. RESULTS A total of 1,015 procedures were performed, 626 were Transperineal Biopsies (TBX) and 389 Transperineal Cryoablations (TPC). There was a statistically significant difference in the mean times of the procedures 22' and 60' for TBX and TPC, respectively. However, pain measures were similar as the median and mean pain referred after TBX were 2 and 2.5 with respective pain measures for TPC of 2 and 1.7. A total of 33 (3%) adverse events within 30 days were recorded, 18 (2.8%) after TBX and 15 after TPC (3.9%). There was one episode of UTI after TBX requiring admission due to presumptive sepsis, however, blood cultures were negative. In the TPC group 4 of the 11 patients with urinary retention greater than 3 weeks required a TURP. There was one patient (TPC) who developed a vasovagal episode and sustained a fall requiring hospital admission CONCLUSIONS Our study shows that transperineal procedures performed under local anesthesia are well tolerated and harbor low rates (<4%) of adverse events. This novel block provides the urologist to access the perineum safely in the office setting © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1089 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Fernando Bianco More articles by this author Jose Antonio Grandez More articles by this author Sergio Lozano-Kaplun More articles by this author Marilin Nicholson More articles by this author Ariel Kaufman More articles by this author Gloria Egui-Benatouil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...