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</o:shapelayout></xml><![endif]--></head><body lang=EN-CA link=blue vlink=purple style='word-wrap:break-word;-webkit-nbsp-mode: space;line-break:after-white-space'><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'>Hi all:<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'>See below for info & registration wrt to an event on Transperineal biopsy.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'>This is of importance to not only men on Active Surveillance but also & an addition to our PCa knowledge base in general.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'>Take care & stay well.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif;mso-fareast-language:EN-US'>Glen<o:p></o:p></span></p><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0cm 0cm 0cm'><p class=MsoNormal><b><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri",sans-serif'>From:</span></b><span lang=EN-US style='font-size:11.0pt;font-family:"Calibri",sans-serif'> Philip Segal <br><b>Sent:</b> April 21, 2021 8:03 PM<br><b>To:</b> Glen Tolhurst- Waterloo-Wellington <glen46nor@gmail.com><br><b>Subject:</b> FW: Upcoming trsnsperineal event<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><b><i><span style='font-size:14.0pt;color:#1F497D'>Glen <o:p></o:p></span></i></b></p><p class=MsoNormal><b><i><span style='font-size:14.0pt;color:#1F497D'>If you’ve got any guys you know on AS this is going to be a really great meeting<o:p></o:p></span></i></b></p><p class=MsoNormal><b><i><span style='font-size:14.0pt;color:#1F497D'>Regards<o:p></o:p></span></i></b></p><p class=MsoNormal><b><i><span style='font-size:14.0pt;color:#1F497D'>Phil<o:p></o:p></span></i></b></p><p class=MsoNormal><b><i><span style='font-size:14.0pt;color:#1F497D'><o:p> </o:p></span></i></b></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;background-size: cover;background-position-x:50%;background-position-y:50%'><tr><td valign=top style='background:#4CAAD8;padding:15.0pt 0cm 15.0pt 0cm;background-size: cover;background-position-x:50%;background-position-y:50%' id=templateHeader><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm;background-size: cover;background-position-x:50%;background-position-y:50%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:6.75pt 6.75pt 6.75pt 6.75pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:0cm 6.75pt 0cm 6.75pt'><p class=MsoNormal align=center style='text-align:center'><a href="https://aspatients.us19.list-manage.com/track/click?u=827de85e4049367ea0e29d44c&id=5601ff59f0&e=5a2606fbd9" target="_blank"><span style='border:solid windowtext 1.0pt;padding:0cm;text-decoration:none'><img border=0 width=318 height=318 style='width:3.3125in;height:3.3125in' id="Picture_x0020_51" src="cid:image003.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span></a><o:p></o:p></p></td></tr></table></td></tr></table></td></tr></table></div></td></tr><tr><td valign=top style='padding:0cm 0cm 0cm 0cm;background-size: cover;background-position-x:50%;background-position-y:50%' id=templateBody><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;background-size: cover;background-position-x:50%;background-position-y:50%'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm;background-size: cover;background-position-x:50%;background-position-y:50%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:6.75pt 0cm 0cm 0cm;max-width:100%;min-width: 100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:0cm 13.5pt 6.75pt 13.5pt'><h1 align=center style='margin:0cm;text-align:center;line-height:45.0pt'><span style='font-size:30.0pt;color:#222222'>Transperineal biopsies:<br>What are they and are they safer?<o:p></o:p></span></h1></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:6.75pt 0cm 0cm 0cm;word-break:break-word'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width="100%" style='width:100.0%;border-collapse:collapse;word-break:break-word'><tr><td valign=top style='padding:0cm 13.5pt 6.75pt 13.5pt;max-width:100%;min-width: 100%'><p class=MsoNormal style='mso-margin-top-alt:7.5pt;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm;line-height:18.0pt'><span style='font-size:13.5pt;color:black'>Transperineal (TP) biopsies are emerging as the biggest trend in the care of men on AS for prostate cancer since the mpMRI and genomic testing. The European Urological Association in January 2021 recommended TP as the first choice for biopsies. The American Urological Association will be debating this technology change at its annual meeting in the fall.</span><span style='color:#757575'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:7.5pt;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm;line-height:18.0pt'><span style='font-size:13.5pt;color:black'>A.S.P.I. has assembled an expert panel to discuss why this change is being made, the potential to eliminate sepsis, impact on stewardship of antibiotics, and the differences between transrectal and transperineal biopsies. The discussion will be followed by a question-and-answer period.</span><span style='color:#757575'><o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:7.5pt;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm;line-height:18.0pt'><span style='color:black'>...........................................................................................................................</span><span style='color:#757575'><o:p></o:p></span></p></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:6.75pt 13.5pt 6.75pt 13.5pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='background:#404040;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=200 style='width:150.0pt;border-collapse:collapse'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm'><p class=MsoNormal><span style='border:solid windowtext 1.0pt;padding:0cm'><img border=0 width=200 height=200 style='width:2.0833in;height:2.0833in' id="Picture_x0020_52" src="cid:image004.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span><o:p></o:p></p></td></tr></table><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=right width=346 style='width:259.5pt;border-collapse:collapse'><tr><td valign=top style='padding:13.5pt 13.5pt 13.5pt 0cm'><p class=MsoNormal style='line-height:15.75pt'><strong><span style='font-size:13.5pt;color:#F2F2F2'>Ferdinand Becker, MD</span></strong><span style='font-size:10.5pt;color:#F2F2F2'> experienced sepsis in 2011 as a result of a transrectal biopsy performed by a personal friend. It nearly killed him. Subsequently, he underwent two uneventful transperineal biopsies in 2012 and 2014 while in the bore of an MRI at Brigham and Women’s Hospital in Boston. Becker was one of the original participants in ASPI. He practiced facial surgery in Vero Beach, Florida, for 45 years and retired to New Orleans in 2017.<o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:6.75pt 13.5pt 6.75pt 13.5pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='background:#404040;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=200 style='width:150.0pt;border-collapse:collapse'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm'><p class=MsoNormal><span style='border:solid windowtext 1.0pt;padding:0cm'><img border=0 width=200 height=200 style='width:2.0833in;height:2.0833in' id="Picture_x0020_53" src="cid:image004.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span><o:p></o:p></p></td></tr></table><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=right width=346 style='width:259.5pt;border-collapse:collapse'><tr><td valign=top style='padding:13.5pt 13.5pt 13.5pt 0cm'><p class=MsoNormal style='line-height:15.75pt'><strong><span style='font-size:13.5pt;color:#F2F2F2'>Richard J. Szabo, MD</span></strong><span style='font-size:10.5pt;color:#F2F2F2'> is a clinical associate professor in the Department of Urology at University of California, Irvine and is on staff at Kaiser Permanente Orange County and Riverside, California. He has written extensively about the new transperineal approach and has a special interest in teaching "free-hand" transperineal prostate biopsy under local anesthesia to his colleagues and informing the general public of the technique's advantages over the transrectal approach.<o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:6.75pt 13.5pt 6.75pt 13.5pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='background:#404040;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=200 style='width:150.0pt;border-collapse:collapse'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm'><p class=MsoNormal><span style='border:solid windowtext 1.0pt;padding:0cm'><img border=0 width=200 height=200 style='width:2.0833in;height:2.0833in' id="Picture_x0020_54" src="cid:image004.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span><o:p></o:p></p></td></tr></table><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=right width=346 style='width:259.5pt;border-collapse:collapse'><tr><td valign=top style='padding:13.5pt 13.5pt 13.5pt 0cm'><p class=MsoNormal style='line-height:15.75pt'><strong><span style='font-size:13.5pt;color:#F2F2F2'>Rick Popert MB MS, FRCS (Urology</span></strong><span style='font-size:10.5pt;color:#F2F2F2'>) is a self-proclaimed “prostatologist.” He is one of the authors along with other leading urologists of a document calling for abandonment of transrectal biopsies. Their plan is known as TRexit. Popert is Senior Urological Surgeon at Guy’s Hospital. In September 2017, Guy’s Hospital stopped all transrectal biopsies after he introduced a new technique, the PrecisionPoint Transperineal Access System<sup>.</sup>.<o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:6.75pt 13.5pt 6.75pt 13.5pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='background:#404040;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=200 style='width:150.0pt;border-collapse:collapse'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm'><p class=MsoNormal><span style='border:solid windowtext 1.0pt;padding:0cm'><img border=0 width=200 height=200 style='width:2.0833in;height:2.0833in' id="Picture_x0020_55" src="cid:image004.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span><o:p></o:p></p></td></tr></table><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=right width=346 style='width:259.5pt;border-collapse:collapse'><tr><td valign=top style='padding:13.5pt 13.5pt 13.5pt 0cm'><p class=MsoNormal style='line-height:15.75pt'><strong><span style='font-size:13.5pt;color:#F2F2F2'>Jonah Rusere</span></strong><span style='font-size:10.5pt;color:#F2F2F2'> is Mr. Popert’s advanced care urology nurse at Guy’s Hospital in London. Rusere will explain the advantages to hospitals to having nurses perform these procedures. He established an accredited program to teach urology nurses how to perform transperineal biopsies. For these efforts, the British Journal of Nursing Urology named Rusere “2021 Nurse of The Year.”<o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='padding:6.75pt 13.5pt 6.75pt 13.5pt'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse'><tr><td valign=top style='background:#404040;padding:0cm 0cm 0cm 0cm'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width=200 style='width:150.0pt;border-collapse:collapse'><tr><td valign=top style='padding:0cm 0cm 0cm 0cm'><p class=MsoNormal><span style='border:solid windowtext 1.0pt;padding:0cm'><img border=0 width=200 height=200 style='width:2.0833in;height:2.0833in' id="Picture_x0020_56" src="cid:image004.jpg@01D736F1.21BAAFA0" alt="Image removed by sender."></span><o:p></o:p></p></td></tr></table><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=right width=346 style='width:259.5pt;border-collapse:collapse'><tr><td valign=top style='padding:13.5pt 13.5pt 13.5pt 0cm'><p class=MsoNormal style='line-height:15.75pt'><strong><span style='font-size:13.5pt;color:#F2F2F2'>Matthew Allaway, MD</span></strong><span style='font-size:10.5pt;color:#F2F2F2'>, is CEO and co-founder of Perineologic, the Cumberland, Maryland developer of the PrecisionPoint Transperineal Access System. He designed the system with men on AS in mind in an effort to reduce risks of infection and increase the odds of finding prostate cancers in areas transrectal biopsies typically miss.<o:p></o:p></span></p></td></tr></table></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:6.75pt 0cm 0cm 0cm;word-break:break-word'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width="100%" style='width:100.0%;border-collapse:collapse;word-break:break-word'><tr><td valign=top style='padding:0cm 13.5pt 6.75pt 13.5pt;max-width:100%;min-width: 100%'><p class=MsoNormal align=center style='mso-margin-top-alt:7.5pt;margin-right:0cm;margin-bottom:7.5pt;margin-left:0cm;text-align:center;line-height:18.0pt'><em><b><span style='font-size:16.5pt;color:mediumblue'>Our April 24 Zoom meeting will begin at 12 P.M. EDT.</span></b></em><b><i><span style='font-size:16.5pt;color:mediumblue'><br><em>Please use the button below to register in advance</em></span></i></b><span style='color:#757575'><o:p></o:p></span></p></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:0cm 13.5pt 13.5pt 13.5pt'><div align=center><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 style='background:#2BAADF;border-top-left-radius: 4px;border-top-right-radius: 4px;border-bottom-right-radius: 4px;border-bottom-left-radius: 4px'><tr><td style='padding:13.5pt 13.5pt 13.5pt 13.5pt'><p class=MsoNormal align=center style='text-align:center'><span style='font-size:22.5pt;font-family:"Arial",sans-serif;color:black'><a href="https://aspatients.us19.list-manage.com/track/click?u=827de85e4049367ea0e29d44c&id=f2c006a1ca&e=5a2606fbd9" target="_blank" title="REGISTER HERE"><b><span style='color:white;text-decoration:none'>REGISTER HERE</span></b></a></span><span style='font-size:22.5pt;font-family:"Arial",sans-serif'><o:p></o:p></span></p></td></tr></table></div></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td valign=top style='padding:6.75pt 0cm 0cm 0cm;word-break:break-word'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 align=left width="100%" style='width:100.0%;border-collapse:collapse;word-break:break-word'><tr><td valign=top style='padding:0cm 13.5pt 6.75pt 13.5pt;max-width:100%;min-width: 100%'></td></tr></table></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td style='padding:13.5pt 13.5pt 13.5pt 13.5pt;min-width: 100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td style='border:none;border-top:solid #BAB2B2 4.5pt;padding:0cm 0cm 0cm 0cm;min-width: 100%'></td></tr></table></td></tr><tr><td valign=top style='padding:0cm 13.5pt 13.5pt 13.5pt'><div align=center><table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 style='background:#2BAADF;border:solid windowtext 1.0pt'><tr><td style='border:none;padding:13.5pt 13.5pt 13.5pt 13.5pt'><p class=MsoNormal align=center style='text-align:center'><span style='font-size:18.0pt;font-family:"Arial",sans-serif'><o:p> </o:p></span></p></td></tr></table></div></td></tr></table><p class=MsoNormal><o:p> </o:p></p><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td style='padding:13.5pt 13.5pt 13.5pt 13.5pt;min-width: 100%'><table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;border-collapse:collapse;min-width: 100%'><tr><td style='border:none;border-top:solid #BAB2B2 4.5pt;padding:0cm 0cm 0cm 0cm;min-width: 100%'></td></tr></table></td></tr></table><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p></o:p></span></p></td></tr></table></div></td></tr></table><div><p class=MsoNormal><o:p> </o:p></p></div></div></div></body></html>