Presented by: T. Max Shelton MD
Indiana University School of Medicine

Introduction

Patient literacy in medical treatment is essential to providing quality patient-centered care. Holmium laser enucleation of the prostate (HoLEP) was first described in the 1990s and has established itself as a durable and cost-effective surgical treatment for benign prostatic hyperplasia (BPH). This study aims to evaluate patient knowledge of HoLEP among patients who underwent this procedure at Indiana University Health between 2019 and 2022. 

Materials

This retrospective cohort study included a survey of eight multiple choice questions which was sent via SMS text message to 2322 patients who previously underwent HoLEP at Methodist Hospital. Data was collected using research electronic data capture (REDCap). A total of 59 patients responded to the survey.   

Results

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Of those contacted, 59 patients responded to the survey (2.5% of total). The average age was 69.5 years at the time of surgery. 93% of patients did not have any BPH surgical treatments prior to HoLEP. The average time between surgery date and survey response was 31 months. A total of 69.5% of patients were referred by local urologists and 15% by their primary care physician (PCP). Less than a third of patients sought out multiple opinions on treatment options and even less (13.6%) traveled from out of state for treatment. Of those who did travel, 75% were from neighboring states. Outside of HoLEP, TURP and Urolift were the most well-known procedures with 58% and 36% of respondents respectively hearing of the procedures preoperatively. 88% of patients who underwent HoLEP reported satisfaction and would recommend the procedure to a friend or family member. The most common reasons listed for the 7 patients who would not recommend the procedure were prolonged leakage and affected sexual performance.  

Conclusion

Patients were more likely to be referred by their urologist than hear of HoLEP from their PCP, online source, or friend. Over half of patients had knowledge of other BPH surgical procedures preoperatively, but most patients did not seek out multiple opinions or undergo any surgical treatments prior to HoLEP. Overall patient satisfaction remained high after an average of 2.5 years post-operatively. Further studies are warranted to analyze PCP HoLEP awareness and referral practices. 

 

Funding

None

Co-Authors

Rachel Gross,
Indiana University School of Medicine

Saveda Majety,
Indiana University School of Medicine

Mariah Thomas,
Indiana University School of Medicine

RJ Caras, DO
Indiana University School of Medicine

Austen Slade, MD
Indiana University School of Medicine

Marcelino Rivera, MD
Indiana University School of Medicine