Abstracts from the New England Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Scientific Session III: BPH/RECON Selective Laser Enucleation of the Prostate: Preserving Sexual Function without Compromising Urinary Outcomes Benjamin Press, MD , Eric Ghiraldi, DO, Katelyn Johnson, MD, Hari Nair, Postgraduate Research Associate, Daniel Kellner, MD Yale School of Medicine, New Haven, CT, USA Introduction: Holmium laser enucleation of the prostate (HoLEP) is recommended for prostate glands of all sizes and is becoming a popular alternative to the transurethral resection of the prostate (TURP). Side effects of the procedure include stress incontinence, irritative lower urinary tract symptoms, and sexual function, most commonly retrograde ejaculation. Our goal was to evaluate perioperative outcomes related to sexual function and urinary function in patients who underwent selective laser enucleation of the prostate. Materials & Methods: Retrospective review of the first 150 cases of HoLEP was performed from May to December 2020. Twelve patients within our cohort underwent selective enucleation of the prostate for an intravesical median lobe or a high bladder neck. Criteria for choosing to treat patients with selective enucleation must have the above criteria without obstructing lateral lobes. Patients were asked to comment onwhether they had retrograde ejaculation during their follow up appointment. Urinary function was assessed using the American urological association symptom score (AUA- SS) and asking if they were experiencing urinary incontinence during their follow up appointment. Descriptive statistics and student t-test was used to assess outcomes. Results: Mean age of our cohort was 64.2 years of age (Range 52-82 years). One of our patients was in urinary retention requiring an indwelling foley catheter prior to surgery. Average peri-operativeAUA-SS scores significantly improved (22.6 vs. 3.7, p=0.0003). Average peri-operative quality of life scores significantly improved (4.5 vs 0, p=<0.0001). Average peri-operative post void residual volumes were significantly improved (257.9 vs. 60.8, p = 0.04). Of the 12 patients undergoing selective enucleation, 7 patients reported normal ejaculation after the procedure. Two patients were not sexually active prior to their procedure. Data was missing from two patients. One patient had retrograde ejaculation. One patient had to be placed on Myrbetriq post- operatively for persistent irritative voiding symptoms. Conclusions: In our case series of selective laser enucleation of the prostate urinary function significantly improved peri-operativelywith preservation of ejaculation in the majority of our patients. A larger series is necessary with a longer followup period to further investigate the durability of these findings. 14 25 26 Assessing the Quality and Content of Online Information About Benign Prostatic Hyperplasia Tremearne Hotz, BS 1 , Molly E. Reissmann, MD 2 , Shaun E.L. Wason, MD 2 , David S. Wang, MD 2 1 Boston University School of Medicine, Boston, MA, USA; 2 Boston University Medical Center, Boston, MA, USA Introduction: Benign Prostatic Hyperplasia (BPH) is a common disease, affecting around half of men over the age of 50 worldwide. While urologists specialize in treatment of BPH, general practitioners are often the first physicians to diagnose and start medical treatment for BPH. Consequently, it is common for patients to search the Internet before and after urologic consultation to better understand their diagnosis and treatment options. However, online health information is not well regulated and may be unreliable or difficult for patients to access or comprehend. This study aims to evaluate the readability and quality of available websites describing BPH treatment options. Materials & Methods: Three search engines, Google, Bing, andDuckDuckGo, were used to search the terms “BPH,” “BPH surgery,” and “BPH treatment” to replicate a patient seeking self-education about BPH. 62 websites were identified, 23 of which were designated advertisements. Three readability formulas (Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease, SMOG) were used to generate readability scores. The DISCERN standardized questionnaire was used to evaluate website quality. Results: According to two out of three readability formulas, mean readability scores for the websites analyzed were in line with the American Medical Association-recommended 7 th grade reading level. The mean DISCERN score for all websites was 68, equating to “Excellent” quality. However, the DISCERN scores for advertisements were significantly lower than non-advertisements (48.8 vs. 74.2, t = -23.3, p <0.05), being rated of “Fair” quality versus the “Excellent” quality of non-advertisements. Additionally, we noted that of the sites advertised in search results 58.3% were selling herbal supplements. Conclusions: Overall, websites about BPH treatment are written at the recommended 7 th grade reading level. However, it is also clear that advertised websites, which hold the most optimal search result positions, have lower quality, reliability, and are largely selling unproven herbal supplements. We postulate that this gives supplement companies, who largely have unproven products and heavy bias, an outsized influence on the online education of patients with BPH.