(506) Patient Understanding of Sexual Side Effects and Risks of Surgical Interventions for Benign Prostatic Hyperplasia – A Prospective, Mixed-Methods Study

Introduction As the number of surgical treatments for benign prostatic hyperplasia (BPH) increases, ensuring patients have adequate information to make an informed decision in their choice of treatment modality becomes more complex. Different BPH surgeries carry vastly different risks for erectile dysfunction, ejaculatory dysfunction, sensory changes, and other potential sexual side effects. However, the extent to which patients undergoing these procedures understand the sexual health side effects and risks of these surgeries or their qualitative sexual health after these surgeries is unknown. Objective The goal of this study is to describe patient understanding of the sexual health risks of various surgical treatments for BPH. Methods This ongoing study consists of prospective, semi-structured interviews with men scheduled for BPH surgery at a large referral tertiary care center beginning in September 2024. Interviewees were asked to describe their procedure; the sexual health side effects and risks of their procedure; and satisfaction with their understanding of their procedure. A list of 12 common surgical risks was generated, and patients’ understanding of those risks was quantified as either incomplete, ≤25% of risks correctly verbalized; partial, 26-75% of risks correctly verbalized; or complete, >75% of risks correctly verbalized. Results Nineteen men were interviewed between September 2024 - October 2025 (age range 52-79, median 70.6); 84.2% of participants had a college degree or higher. Most participants received a Holmium laser enucleation of the prostate (HoLEP; 57.9%), with others receiving GreenLight laser therapy (15.8%), a simple prostatectomy (15.8%), transurethral resection of the prostate (TURP; 5.3%), or Rezum water vapor therapy (5.3%). No participant demonstrated a complete understanding of the risks of their surgery, and one participant was unable to identify any risks of his surgery. The most frequently cited risks were infection (42.1% of participants) and damage to surrounding structures (31.6% of participants). Participants demonstrated a low degree of understanding of risks regarding sexual function, with 68.5% failing to identify erectile dysfunction as a possible risk of their BPH surgery and 63.2% failing to identify retrograde ejaculation as a known side effect. 94.7% of participants were satisfied with their understanding of the risks of their surgery. Conclusions Participants generally had a high degree of formal education but consistently were unable to identify common sexual health risks of their BPH procedure including erectile dysfunction and retrograde ejaculation, indicating that even well-educated individuals may still need additional support to understand surgical risks and side effects. Additionally, paradoxically, while participants expressed high levels of satisfaction with their understanding of the risks of their surgeries, none had a complete understanding. Through follow-up interviews, this study will explore qualitative experiences with sexual health side effects. To better understand how surgical outcomes impact patient satisfaction with the decision-making process, these variables will be reassessed after their surgeries. Disclosure No