Dear Mr. Wolinsky,

We appreciate and share your concerns about prostate infections.  However, we don’t issue guidelines or recommendations outside of the larger process with our partner organizations such as the AUA.  We would suggest discussing this issue with the AUA. They have the infrastructure to assess different diagnostic modalities in a rigorous and thoughtful way.

Thank you,

Barbara Arango, MBA
Executive Director | SUO
Direct: 847.264.5969 | Main: 847.264.5901| Cell: 269.312.4491

Two Woodfield Lake | 1100 E Woodfield Road, Suite 350 | Schaumburg, IL 60173 

barbara@wjweiser.com | www.suonet.org

From: Howard Wolinsky <howard.wolinsky@gmail.com>
Sent: Sunday, April 18, 2021 1:24 PM
To: Weldon, Holly N. (HSC) <Holly-Weldon@ouhsc.edu>
Subject: [EXTERNAL] ATTN: Dr. Cookson, President of SUO

 
Dr. Cookson,
I am writing as a patient who has been on AS for 10 years to request that SUO address the safety concerns of transrectal biopsies and support a switchover to modern transperineal biopsies. 
 
I hope that as President of SUO you can direct  your organization to address the need for guidelines that  support the use of safer new transperineal biopsies to replace transrectal biopsies,
 
Based on research in Norway, it is estimated that 2,000 American men die from sepsis caused by transrectal biopsies. That would be based on 2 million of these biopsies per year. Dr. Truls E.B.Johansen, of Oslo University Hospital) performed this research. (see attached studies.)
 
One of Dr. Johansen's patients, Roar Gulbrandsen died from a brain clot following a biopsy. Agnes Gulbrandsen, the patient's daughter, pushed for a probe that turned in a national debate in Norway on the safety of TR biopsies and a switchover to transperineal and education for hospital staff on sepsis prevention.  I wrote a column on what happened in Norway, See: https://howardwolinsky.medium.com/death-by-prostate-biopsy-5b5bb9c0bf5a
 
Leading urologists coauthored this call to abandon TR by 2022 with TRexit: https://www.nature.com/articles/s41391-020-0204-8
 
Dr. Richard Zabo, of UC-Irvine, has written literature reviews on TR v. TP and found that not only can TP save lives and prevent disabilities but also money. https://www.liebertpub.com/doi/abs/10.1089/end.2020.1093
 
The Medicare national health program in Australia has given preferential reimbursement for TP and reduced reimbursement by half for TR.
 
The European Association of Urology in January 2021 issued a position paper that states: “Available evidence highlights that it is time for the urological community to switch from a transrectal to a transperineal [prostate biopsy] approach despite any possible logistical challenges.” https://www.sciencedirect.com/science/article/pii/S0302283820308083 
 
The European guidelines could serve as a template for new guidelines in the U.S. from SUO.
 
Now is the time for SUO  to act in the interest of patient health and safety
 
I wrote a Change.org petition summarizing findings: http://chng.it/mcv6Ys4shV
 
I helped organize a webinar for Active Surveillance Patients International a webinar featuring leaders in the TRexit (Transrectal exit ) movement at noon Eastern April 24. Here is the program: https://aspatients.org/event/transperineal-biopsies-what-are-they/
Register here: https://us02web.zoom.us/meeting/register/tZYof-Chpz8qG9zi24_4RDdmzNtKaZPHlvBe?_x_zm_rtaid=YQeDQ4l5S-WmmzQ-YSIBlw.1617654454522.d1b2862a67bb82e57db7bf0bb9dad6bb&_x_zm_rhtaid=918
 
I hope you can attend as an observer and would welcome your comments. 
 
Howard Wolinsky