Patient-reported Goal and Goal Achievement: The Most Individualized Method of Outcome Assessment in Patients with Lower Urinary Tract Symptoms

Patients with lower urinary tract diseases often have a constellation of symptoms, and the degree of distress due to individual symptoms varies. In particular, some symptoms are more bothersome to patients and lead to treatment. However, traditional outcomes, such as urodynamic data, voiding diaries, and standardized patient-reported outcomes, may fail to address the individual factors. In contrast, patient-centered outcomes rely on patients to assess treatment outcomes in terms of their concerns or goals. Goal achievement is a patient-centered outcome that was pioneered in prolapse surgery. Recently, this most individualized outcome measure has been evaluated in the context of lower urinary tract symptoms (LUTS). According to the studies, most patients with LUTS have symptom-related goals. After treatment, goal achievement in patients with overactive bladder or benign prostatic obstruction was low even when there were significant improvements in symptom severity in terms of traditional outcome measures. On the other hand, most women with stress incontinence achieved their treatment goals after midurethral sling surgeries. There are ongoing efforts to develop valid and reliable methods for assessing goal achievement that can facilitate the complex rating process and have responsiveness. Goal achievement shows a limited correlation with standardized patient-reported outcomes and no significant correlation with objective outcomes. Thus, at the moment, it can be used as a complimentary outcome measure along with other traditional methods. Further research is needed to reveal the correlation between goal achievement and overall patient satisfaction and, ultimately, to determine if assessing goal achievement can enhance patient satisfaction.