Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): Association with patients' postoperative satisfaction

Abstract

This study aimed to determine serial changes in self-assessed goal achievement (SAGA) and treatment satisfaction after HoLEP, to identify correlations between the two, and to compare them with results assessed by traditional outcome measures. For a total of 170 patients, outcomes were evaluated serially at postoperative 1-, 3-, 6-, and 12-months using IPSS, OABSS, SAGA questionnaires and uroflowmetry. The SAGA questionnaire consisted of five questions including one open-ended question (self-assessed goals and degree of SAGA) and another question regarding treatment satisfaction. The number of self-assessed treatment goals was two or more in 74.1% of the patients. Most common treatment goal was relief from straining/hesitancy, followed by increased daytime frequency, nocturia and feeling of incomplete emptying. Degree of achievement for the first or second goal and treatment satisfaction tended to increase with time throughout the follow-up period. Patients with the greatest treatment satisfaction scores showed greater improvement by traditional outcome parameters including quality of life (QOL) index, total OABSS, maximum flow rate (Qmax), post-void residual urine volume (PVR) and bladder voiding efficiency (BVE) compared to those without treatment satisfaction. After adjusting for other influential variables, the improvements in subjective outcome parameters including total IPSS, QOL index and total OABSS were significantly associated with treatment satisfaction, but improvements in objective outcome parameters including Qmax, PVR and BVE were not. In addition, the degree of SAGA for the first goal or second goal was more predictive in determining treatment satisfaction than the traditional outcome measures. In conclusion, treatment goals of patients with lower urinary tract symptoms (LUTS)/BPH vary from individual to individual. The degree of SAGA and treatment satisfaction for HoLEP tends to increase with time throughout the follow-up period. Compared to the traditional outcome measures, the degree of goal achievement can be more predictive when assessing patient-centered outcomes such as treatment satisfaction.

Outcome of Patients With Elevated Prostate-Specific Antigen and Lower Urinary Tract Symptoms Receiving Holmium Laser Enucleation of the Prostate

“…Lee et al [26] reported that 91.8% of patients were satisfied with the surgical outcomes of HoLEP, and 94% reported that they would choose surgery if they had to reconsider. Our study showed improvements in objective and subjective symptoms in the 6-month analysis, which is consistent with recent studies [27].…”

Understanding holmium laser enucleation of the prostate (HoLEP) recovery: Assessing patient expectations and understanding

“…Further supporting the importance of communicating patient defined goals and expectations, 170 patients were examined across validated surveys before and after HoLEP at 1, 3, 6 and 12 months (13). Prior to HoLEP, patient determined key self-assessed goals of the treatment and were subsequently asked to provide self-assessed goal achievement (SAGA) and overall satisfaction scores.…”

Aquablation versus holmium laser enucleation of the prostate in the treatment of benign prostatic hyperplasia in medium-to-large-sized prostates (ATHLETE): protocol of a prospective randomised trial

“…Out of this cooperation, we were able to learn that standardised patient-reported outcome measures (ie, questionnaires) and voiding parameters often do not address the main concern of individual patients appropriately. Therefore, we included the SAGA 22 in the present trial. Thus, patients can define their main treatment goals prior to treatment, and achievement of goals according to a Likert scale is assessed at each study visit.…”