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

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.Results102 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.