(073) An APP-Driven Diagnostic Pathway for BPH: Improving Surgical Selection and Preserving Sexual Function
Abstract
Benign prostatic hyperplasia (BPH) is a progressive condition affecting both urinary and sexual health in aging men. With increasing interest in procedures that preserve ejaculatory and erectile function, advanced practice providers (APPs) are in a unique position to lead patients through comprehensive evaluation and informed decision-making. At our high-volume urology practice, we developed an APP-led diagnostic algorithm to guide treatment selection and emphasize outcomes that matter most to patients.
To assess the outcomes of a structured, APP-driven BPH workup designed to guide surgical selection, improve lower urinary tract symptoms (LUTS), and minimize sexual side effects. The primary focus was on preserving ejaculatory and erectile function in men undergoing procedural treatment.
All patients were evaluated by an APP using a standardized diagnostic pathway including symptom scoring (IPSS), uroflowmetry, post-void residual (PVR), prostate sizing via transrectal ultrasound (TRUS), and cystoscopy. Based on prostate size and anatomy, patients with prostates <50 cc and no median lobe were offered UroLift, while Aquablation was recommended for larger glands or more obstructive features. The APP managed all preoperative counseling, education, and coordination. Postoperative follow-up included evaluation of LUTS and sexual function.
Between 2022 and 2024, 164 patients underwent BPH surgery following APP-led workup: 68 received UroLift and 96 underwent Aquablation. This…
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