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

To evaluate the concordance between the postoperative priorities of urologists who perform enucleation surgery and patients who are candidates for surgery.

This cross-sectional study utilized a structured face-to-face survey research design between June and August 2025 in a total of four urology clinics. We included men ≥50 years with lower urinary tract symptoms, excluding those with prior prostate surgery. The study involved administering questionnaires to both urologists who perform enucleation surgery and patients who are candidates for the procedure. The collected data were subsequently analyzed to compare the priorities of surgeons and patients.

A total of 82 urologists and 622 patients were included in the study. Mean IPSS of patients was 17.8 ± 5.5, and mean IIEF-5 score was 15.9 ± 6.3. Surgeons identified continence as the highest priority (45.7% ranked it first, 44.4% second). Patients also ranked continence as the top priority (34.7% first, 27.2% second), although their responses were more widely distributed across lower ranks. Surgeons prioritized continence more strongly than patients (P = .001). Ejaculation was ranked lowest by surgeons (51.9% ranked it fifth), with none ranking it first. In contrast, patients assigned greater importance to ejaculation (4.7% first, 14.5% second, 16.7% third) (P = .005). Before enucleation surgery, 14.8% of urologists omitted information on ejaculation, 30.9% on erectile function, and 6.2% on continence.

Both patients and surgeons prioritized effective urination and continence following enucleation surgery. Ejaculation, however, was assigned low priority by surgeons, whereas certain groups of patients regarded it as an important outcome.