Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Nair SM, Pimentel MA, Gilling PJ (2015) Evolving and investigational therapies for benign prostatic hyperplasia. Can J Urol 22(Suppl 1):82–87

    PubMed  Google Scholar 

  2. Malde S, Umbach R, Wheeler JR, Lytvyn L, Cornu JN, Gacci M et al (2021) A systematic review of patients’ values, preferences, and expectations for the diagnosis and treatment of male lower urinary tract symptoms. Eur Urol 79:796–809

    Article  PubMed  Google Scholar 

  3. Yao MW, Green JSA (2022) How international is the International Prostate Symptom Score? A literature review of validated translations of the IPSS, the most widely used self-administered patient questionnaire for male lower urinary tract symptoms. Low Urin Tract Symptoms 14:92–101

    Article  PubMed  Google Scholar 

  4. Eckhardt MD, van Venrooij GE, van Melick HH, Boon TA (2001) Prevalence and bothersomeness of lower urinary tract symptoms in benign prostatic hyperplasia and their impact on well-being. J Urol 166:563–568

    Article  CAS  PubMed  Google Scholar 

  5. Ashford S, Turner-Stokes L (2006) Goal attainment for spasticity management using botulinum toxin. Physiother Res Int 11:24–34

    Article  PubMed  Google Scholar 

  6. Barber MD, Brubaker L, Nygaard I, Wheeler TL 2nd, Schaffer J, Chen Z et al (2009) Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 114:600–609

    Article  PubMed  PubMed Central  Google Scholar 

  7. Mahajan ST, Elkadry EA, Kenton KS, Shott S, Brubaker L (2006) Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery. Am J Obstet Gynecol 194:722–728

    Article  PubMed  Google Scholar 

  8. Rockwood K, Graham JE, Fay S, Investigators A (2002) Goal setting and attainment in Alzheimer’s disease patients treated with donepezil. J Neurol Neurosurg Psychiatry 73:500–507

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Brubaker L, Kopp Z, Piault E, Trocio J, Evans C, Fitzgerald K et al (2007) Development of a self-assessment goal achievement (SAGA) questionnaire in urinary disorders. International Continence Society, Rotterdam

    Google Scholar 

  10. Brubaker L, Khullar V, Piault E, Evans CJ, Bavendam T, Beach J et al (2011) Goal attainment scaling in patients with lower urinary tract symptoms: development and pilot testing of the self-assessment goal achievement (SAGA) questionnaire. Int Urogynecol J 22:937–946

    Article  PubMed  Google Scholar 

  11. Brubaker L, Piault EC, Tully SE, Evans CJ, Bavendam T, Beach J et al (2013) Validation study of the self-assessment goal achievement (SAGA) questionnaire for lower urinary tract symptoms. Int J Clin Pract 67:342–350

    Article  CAS  PubMed  Google Scholar 

  12. Piault E, Doshi S, Brandt BA, Angün Ç, Evans CJ, Bergqvist A et al (2012) Linguistic validation of translation of the self-assessment goal achievement (saga) questionnaire from English. Health Qual Life Outcomes 10:40

    Article  PubMed  PubMed Central  Google Scholar 

  13. Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T et al (2018) WATER: a double-blind, randomized, controlled trial of aquablation® vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol 199:1252–1261

    Article  PubMed  Google Scholar 

  14. Abt D, Lyatoshinsky P, Schmid H-P, Müllhaupt G (2022) Prostatic artery embolisation: do we still need it and for whom? Eur Urol Focus 8:384–387

    Article  PubMed  Google Scholar 

  15. Abt D, Hechelhammer L, Müllhaupt G, Markart S, Güsewell S, Kessler TM et al (2018) Comparison of prostatic artery embolisation (PAE) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial. BMJ 361:k2338

    Article  PubMed  PubMed Central  Google Scholar 

  16. Young S, Golzarian J (2019) Prostate embolization: patient selection, clinical management and results. CVIR Endovascular 2:7

    Article  PubMed  PubMed Central  Google Scholar 

  17. Berwick DM (1997) Medical associations: guilds or leaders? BMJ 314:1564–1565

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wadie BS, Ibrahim EH, de la Rosette JJ, Gomha MA, Ghoneim MA (2001) The relationship of the international prostate symptom score and objective parameters for diagnosing bladder outlet obstruction. Part I: when statistics fail. J Urol 165:32–34

    Article  CAS  PubMed  Google Scholar 

  19. Marschall-Kehrel D, Roberts RG, Brubaker L (2006) Patient-reported outcomes in overactive bladder: the influence of perception of condition and expectation for treatment benefit. Urology 68:29–37

    Article  PubMed  Google Scholar 

  20. Das AK, Teplitsky S, Chandrasekar T, Perez T, Guo J, Leong JY et al (2020) Stress urinary incontinence post-holmium laser enucleation of the prostate: a single-surgeon experience. Int Braz J Urol 46:624–631

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rockwood K, Howlett S, Stadnyk K, Carver D, Powell C, Stolee P (2003) Responsiveness of goal attainment scaling in a randomized controlled trial of comprehensive geriatric assessment. J Clin Epidemiol 56:736–743

    Article  PubMed  Google Scholar 

  22. Adellund Holt K, Hansen DG, Mogensen O, Jensen PT (2019) Self-assessment of goal achievements within a gynecological cancer rehabilitation counseling. Cancer Nurs 42:58–66

    Article  PubMed  Google Scholar 

  23. Kristman V, Manno M, Côté P (2004) Loss to follow-up in cohort studies: how much is too much? Eur J Epidemiol 19:751–760

    Article  PubMed  Google Scholar 

  24. Cho MC, Kim JK, Ha SB, Ku JH, Paick JS (2018) Self-assessed goal achievement (SAGA) after Holmium laser enucleation of the prostate (HoLEP): association with patients’ postoperative satisfaction. PLoS One 13:e0203825

    Article  PubMed  PubMed Central  Google Scholar 

  25. Homma Y, Yoshida M, Seki N, Yokoyama O, Kakizaki H, Gotoh M et al (2006) Symptom assessment tool for overactive bladder syndrome–overactive bladder symptom score. Urology 68:318–323

    Article  PubMed  Google Scholar 

  26. Rotenstein LS, Huckman RS, Wagle NW (2017) Making patients and doctors happier—the potential of patient-reported outcomes. N Engl J Med 377:1309–1312

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge Sigrid Patzl — clinical research coordinator, Clinical Trials Unit St. Gallen – Data Management; as well as all the patients and staff involved in gathering the outcomes assessed.

Author information

Authors and Affiliations

  1. Department of Urology, School of Medicine, University of St. Gallen, St. Gallen, Switzerland

    Manolis Pratsinis, Gautier Müllhaupt, Patrick Betschart, Valentin Zumstein, Daniel Engeler & Hans-Peter Schmid

  2. Department of Urology, University of California, Davis, Sacramento, CA, USA

    Manolis Pratsinis

  3. Clinical Trials Unit, Cantonal Hospital St. Gallen, St. Gallen, Switzerland

    Sabine Güsewell

  4. Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

    Alastair D. Lamb

  5. Department of Urology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    Alastair D. Lamb

  6. Department of Urology, Spitalzentrum Biel/Centre Hospitalier Bienne, Biel/Bienne, Switzerland

    Dominik Abt

Authors
  1. Manolis Pratsinis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gautier Müllhaupt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabine Güsewell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patrick Betschart
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valentin Zumstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Daniel Engeler
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hans-Peter Schmid
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alastair D. Lamb
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Dominik Abt
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MP: protocol/project development, data collection and management, data analysis, manuscript writing. GM: protocol/project development, data collection and management, manuscript editing. SG: protocol/project development, data analysis, manuscript editing. PB: data collection and management, manuscript writing. VZ: data collection and management, manuscript writing. DE: data collection and management, manuscript writing. H-PS: protocol/project development, manuscript writing. ADL: protocol/project development, manuscript writing. DA: protocol/project development, data collection and management, data analysis, manuscript writing.

Corresponding author

Correspondence to Manolis Pratsinis.

Ethics declarations

Conflict of interest

I certify that all conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript (e.g., employment/affiliation, grants or funding, consultancies, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: (please list all conflict of interest with the relevant author’s name): Manolis Pratsinis currently receives funding from the Swiss Cancer Research Foundation (BIL KFS-5248-02-2021). He has previously received education support from Janssen Pharmaceutica. Gautier Müllhaupt currently receives funding from Blumenau-Léonie-Hartmann Foundation. Sabine Güsewell has no financial disclosures or conflicts of interest to declare. Patrick Betschart has previously received education support from Janssen Pharmaceutica. Valentin Zumstein has no financial disclosures or conflicts of interest to declare. Daniel Engeler has no financial disclosures or conflicts of interest to declare. Hans-Peter Schmid has no financial disclosures or conflicts of interest to declare. Alastair Lamb currently receives funding from Cancer Research UK (C57899/A25812) and the Oxford NIHR Biomedical Research Centre Surgical Innovation & Evaluation theme. He has previously received grant funding from Prostate Cancer UK (PA14-022), The Academy of Medical Sciences (SGCL11), Medical Research Council (CiC), National Institute of Health Research and GlaxoSmithKline. He has received education support from Astellas, Lilly, AstraZeneca and Ipsen. He is a stipendiary BJUI Section Editor for Prostate Cancer and has received honoraria for reviewing for European Urology and Lancet Oncology. He has received consulting fees from AlphaSights. Domink Abt has no financial disclosures or conflicts of interest to declare.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee (EKOS 21/084).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 129 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pratsinis, M., Müllhaupt, G., Güsewell, S. et al. Comparison of traditional outcome measures and self-assessed goal achievement in patients treated surgically for benign prostatic hyperplasia. World J Urol 41, 1125–1131 (2023). https://doi.org/10.1007/s00345-023-04317-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-023-04317-y

Keywords

Search

Navigation