Nurses can safely perform prostate biopsies with no increase in complications

It has been a great pleasure for me to be the candidate from Norway to participate in the EAUN Guidelines panel for the update of Transrectal Ultrasound (TRUS) Guided Prostate Biopsy. The Guidelines group has been working on the update for the last three years.

I was very happy to be present at the session for the presentation of the Update of TRUS guided prostate biopsy guidelines. Corinne Tiller, Chair of the guidelines panel, did a great job presenting the new Guidelines 2019.

The Guidelines show that nurses can safely perform prostate biopsies with no increase in complications, if they are adequately trained and supervised by a competent practitioner. They must, like other new practitioners, perform at least 50 biopsies with supervision before being signed off as competent to practise on their own. Nevertheless, it is essential to confer with an experienced urologist.

Complications after TRUS biopsy

The patients receive an up-to-date, evidence-based and easy to understand PIL (Patient Information Leaflet) prior to TRUS biopsy. It is important to ensure that the information is well understood. The number of cores to detect cancer in the initial prostate biopsies is recommended to 10 – 12. It is not recommended to only perform MRI-targeted biopsies initially.

The Update of the TRUS prostate biopsy contains ‘Complications after TRUS biopsy’ and their incidence. It also contains recommendations with regard to the use of anticoagulants.

The next Guideline update of TRUS-Guided Prostate Biopsy may include perineal prostate biopsy. In one of the sessions we heard that in London only perineal prostate biopsies are performed nowadays and that the frequency of infection is very low in perineal prostate biopsy.

The new version of the guideline has been posted on the EAUN website, Guidelines page, and can be downloaded for free. Also available online are 3 additional downloadable documents:

• A training document
• The complete TRUS biopsy procedure
• A card with a table on when to stop which anti-coagulant or anti-aggregant pre-biopsy that can be very helpful in daily practice

The anticoagulants card was handed out after the session and also available at the EAUN booth in Barcelona.

Thank you for a great congress and I hope to see you all in Amsterdam in 2020!

Ingrid Iversen, Urotherapist, Kristiansund Sykehus, Dept. of Urology & General Surgery, Kristiansund, Norway,  icki@online.no