Introduction: A quality assessment performed at our center revealed 10.9% of patients were not aware that ejaculate volume may change postoperatively, with >25% recommending a patient handout to improve communication. Therefore, a multidisciplinary team created a holmium laser enucleation of the prostate (HoLEP) expectations communication handout to improve surgeon-patient communication. 

Methods: Patients presenting for preoperative consultation prior to HoLEP were assessed with post-procedure patient-reported outcomes (PRO) questionnaires before (n=50) and after (n=50) the implementation of a surgeon-patient HoLEP expectations handout. Patient perioperative course was examined in the context of their responses. Comparisons were made with a Chi-squared test (p<0.05). Our primary objective was to improve patient understanding of retrograde ejaculation and HoLEP recovery. 

Results: We observed a response rate of 96% (46/50 baseline, 50/50 post-handout). Overall, 89/96 (93%) patients felt they had a reasonable understanding of HoLEP expectations, with no significant difference between cohorts (45/46 vs. 48/50, p=0.71). There was no difference in the proportion of respondents reporting an understanding of post-HoLEP dysuria (p=0.59), hematuria (p=0.12), or urinary incontinence (UI) (p=0.99). The implementation of the communication handout improved patient understanding of retrograde ejaculation (41/46 baseline vs. 50/50 post-handout, p=0.022). Fifty-five patients experienced any dysuria postoperatively, with 85% reporting less than or equal to what they expected. Close to 30% (28/94) of respondents offering ways to improve communication suggested a HoLEP website for more information. 

Conclusions: The implementation of a summative surgeon-patient communication handout during preoperative HoLEP consultation improved the understanding of postoperative retrograde ejaculation at our center. We identified additional areas for future technology-aided improvements in post-HoLEP communication.