Comparison of traditional outcome measures and self-assessed goal achievement in patients treated surgically for benign prostatic hyperplasia

World J Urol. 2023 Apr;41(4):1125-1131. doi: 10.1007/s00345-023-04317-y. Epub 2023 Feb 16.


Purpose: To determine self-assessed goal achievement (SAGA) outcomes in men treated surgically for lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) and compare them to the traditional outcome measures.

Methods: Single-center analysis of prospective database of men undergoing surgical treatment of LUTS/BPO at a single institution between July 2019 and March 2021. We assessed individual goals, traditional questionnaires, and functional outcomes prior to treatment, and at first follow-up after 6-12 weeks. We compared SAGA outcomes 'overall goal achievement' and 'satisfaction with treatment' to subjective and objective outcomes using Spearman's rank correlations (rho).

Results: A total of sixty-eight patients completed the individual goal formulation prior to surgery. Preoperative goals varied between different treatments and individuals. IPSS correlated with 'overall goal achievement' (rho = - 0.78, p < 0.001) and 'satisfaction with treatment' (rho = - 0.59, p < 0.001). Similarly, the IPSS-QoL was correlated with overall goal achievement (rho = - 0.79, p < 0.001) and satisfaction with treatment (rho = - 0.65, p < 0.001). No correlation was seen between SAGA outcomes and functional outcomes Qmax and PVR.

Conclusions: SAGA represents a uniquely patient-specific outcome measure. Our study is, to our knowledge, the first to assess patient-specific goals prior to surgery and examine SAGA outcomes following treatment in men suffering from LUTS/BPO. The correlation of SAGA outcomes with IPSS and IPSS-QoL highlight the importance of this well-established questionnaire. Functional outcomes do not necessarily reflect patient's goals and may rather be considered physician-directed outcomes.

Keywords: Benign prostatic hyperplasia; Bladder outlet obstruction; Decision-making; Lower urinary tract symptoms; Patient satisfaction; Patient-reported outcome measures; Self-assessed goal achievement.

MeSH terms

  • Goals
  • Humans
  • Lower Urinary Tract Symptoms* / diagnosis
  • Lower Urinary Tract Symptoms* / etiology
  • Lower Urinary Tract Symptoms* / surgery
  • Male
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / diagnosis
  • Prostatic Hyperplasia* / surgery
  • Quality of Life
  • Treatment Outcome
  • Urethral Obstruction*