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On Tuesday 17th<\/sup> November, we were delighted to attend a presentation by Rick Popert, Consultant Urologist, Guy\u2019s and St Thomas\u2019 Hospital and a Fellow on the NHS Innovation Accelerator, and Advanced Nurse Practitioner, Jonah Rusere, at the annual \u2013 albeit virtual \u2013 conference of the British Association of Urological Nurses (BAUN). Rick and Jonah\u2019s joint presentation discussed Local Anaesthetic Transperineal (LA TP) Prostate Biopsy as it relates to nursing practice. Specifically, this includes an understanding of safe LA TP within an outpatient setting and how the free hand transperineal approach can optimise systemic and targeted sampling of the peripheral zone of the prostate.<\/p>\n\n\n\n
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As Rick Popert commented: \u201cThe current prostate cancer diagnostic pathway was predicated on transrectal biopsies and we know that these have a tendency to undersample the anterior prostate. We know they are associated with the risk of sepsis. This is why we have started a UK-wide initiative \u2013 \u201cTRexit\u201d \u2013 to exit transrectal biopsies.\u201d<\/p>\n\n\n\n
However, transperineal biopsy under general anaesthetic generates waiting lists and delays to the patient pathway. TP grid based biopsies under local anaesthetic are limited to small areas that can be targeted, are not really practical, and are considered \u201ctolerable\u201d, but not \u201ccomfortable\u201d.<\/p>\n\n\n\n
He continued: \u201cI genuinely thought there was no solution until I was introduced to a new technique, the PrecisionPoint™ Transperineal Access System, which allows you to do LA TP systematic and targeted biopsy, but in an outpatient setting.\u201d<\/p>\n\n\n\n
At the time, Jonah Rusere had been conducting all TRUS biopsies at Guy\u2019s and St Thomas\u2019 Hospital. When the Trust decided to stop these in September 2017, it started him on a revolutionary career path, starting with retraining in LA TP biopsy and since teaching and training others, supporting Guy\u2019s own service and supporting wider pathway transformation.<\/p>\n\n\n\n