Understanding Patient and Surgeon Priorities in Prostate Enucleation Surgery: Insights From the ENUC-TR Multicenter...

Area of Science:

• Urology
• Surgical Oncology
• Patient-Centered Care

Background:

• Enucleation surgery is a common procedure for lower urinary tract symptoms.
• Understanding patient and surgeon priorities is crucial for informed consent and shared decision-making.
• Discrepancies in perceived importance of outcomes can impact patient satisfaction.

Purpose of the Study:

• To compare the postoperative priorities of urologists performing enucleation surgery with those of surgical candidates.
• To identify potential areas of misalignment in expectations regarding surgical outcomes.

Main Methods:

• A cross-sectional study involving surveys of 82 urologists and 622 male patients (≥50 years) with lower urinary tract symptoms.
• Data collected via face-to-face questionnaires in four urology clinics.
• Analysis focused on comparing the ranked priorities of surgeons and patients for various postoperative outcomes.

Main Results:

• Both groups prioritized continence and effective urination. Surgeons ranked continence higher (p=0.001).
• Surgeons assigned the lowest priority to ejaculation, whereas a notable percentage of patients considered it important (p=0.005).
• Information regarding ejaculation and erectile function was omitted by a significant proportion of urologists during preoperative discussions.

Conclusions:

• Effective urination and continence are shared priorities for patients and surgeons undergoing enucleation surgery.
• A significant divergence exists in the perceived importance of ejaculatory function, with patients valuing it more than surgeons.
• Preoperative counseling needs to address potential disparities in outcome expectations, particularly concerning sexual function.