The following is a summary of “Current Perceptions, Practice Patterns, and Barriers to Adoption of Transperineal Prostate Biopsy under local anesthesia,” published in the April 2024 issue of Urology by Bulusu et al.
This study aimed to comprehensively evaluate the prevailing perceptions, practice patterns, and impediments hindering the widespread adoption of Transperineal Prostate Biopsy (TPBx) under local anesthesia.
Through a meticulous examination, providers affiliated with the Michigan Urological Surgery Improvement Collaborative (MUSIC) and Pennsylvania Urologic Regional Collaborative (PURC) were administered an online survey meticulously designed to gauge their beliefs and educational requirements about TPBx. Providers were stratified into two cohorts based on their engagement in TPBx procedures. Concurrently, the MUSIC and PURC registries were scrutinized to ascertain the utilization rates of TPBx over time. Employing a combination of descriptive analytics and bivariate analysis, the researchers sought to delineate any discernible associations between provider/practice demographics and prevailing attitudes towards TPBx.
The findings of this study are significant, revealing a notable surge in TPBx adoption, doubling since 2019 to 7.0% and 16% across MUSIC and PURC practices, respectively. Among the 350 urologists invited to participate in the survey, 91 comprehensive responses were garnered, with 21 respondents (23%) identifying themselves as practitioners of TPBx. Participants across both TPBx performers and non-performers estimated a relatively short learning curve of fewer than 10 procedures. Interestingly, no significant correlation was observed between the learning curve and provider age or practice setting. Principal perceived benefits of TPBx included a decreased risk of sepsis, enhanced cancer detection rates, and improved antibiotic stewardship practices. However, significant challenges to implementation were identified, notably encompassing issues related to equipment accessibility and patient experience. Practitioners engaged in TPBx cited the learning curve as an additional obstacle, whereas those abstaining from TPBx expressed concerns regarding procedural duration.
In conclusion, TPBx holds promise as a viable diagnostic modality, and this study’s findings provide a roadmap for its successful implementation. While access to requisite equipment and patient-centric considerations remain formidable barriers, addressing these challenges through the dissemination of techniques utilizing existing resources and the optimization of local anesthetic protocols for TPBx may serve as pivotal strategies in fostering its continued integration into clinical practice.
Source: sciencedirect.com/science/article/abs/pii/S0090429524002929
