Prostate cancer screening and management in patients candidate for endoscopic enucleation of the prostate: an international survey

Prostate Cancer Prostatic Dis. 2024 Oct 21. doi: 10.1038/s41391-024-00909-w. Online ahead of print.

Abstract

Background: To explore how urologists manage prostate cancer (PCa) screening and treatment in patients undergoing endoscopic enucleation of the prostate (EEP).

Methods: A team of experts in EEP collaboratively formulated the survey questions through an interactive process. The survey opened in January 2024 and closed in February 2024.

Results: 102 urologists responded, revealing that most use PSA and digital rectal examination for screening, with high PSA and abnormal DRE prompting prostate MRI. 75% perform pre-EEP biopsies. For incidental low-grade PCa, active surveillance is preferred. For intermediate-grade PCa, most use PSA and MRI for workup, often choosing active surveillance if post-EEP biopsies are negative. There's no consensus on abnormal post-operative PSA thresholds.

Conclusions: While urologists are aware of PCa management in EEP candidates, future work should focus on developing optimal post-EEP screening protocols.