Video-assisted education for informed consent in percutaneous nephrolithotomy: a prospective study on patient comprehension.

Purpose: The prevalence of urinary stone disease is increasing due to climate change, dietary habits, and obesity. Percutaneous nephrolithotomy (PCNL) remains the preferred treatment for large kidney stones. The informed consent process is essential for patient understanding; however, conventional verbal and written methods may be inadequate. This study aimed to evaluate the effectiveness of video-assisted education in improving informed consent for PCNL.

Methods: This randomized controlled study was conducted from January to July 2023. Eighty patients scheduled for PCNL were randomly assigned to either a written-consent-only group or a video-assisted consent group that received both written consent and a seven-minute 3D-animated video. Comprehension was assessed using a 17-question knowledge assessment questionnaire before and after the consent process. Improvements in knowledge and differences in comprehension were compared.

Results: The video-assisted consent group showed significantly greater comprehension improvement than the written-only group, benefiting patients across all education levels. Multivariate analysis confirmed the strong association between video education and knowledge gain, though older age was linked to lower improvement. Despite its effectiveness, two patients withdrew due to increased anxiety, underscoring the need to balance understanding with emotional reassurance.

Conclusion: Video-assisted informed consent significantly improves comprehension in PCNL patients, particularly in those with lower education levels. However, an increased awareness of surgical risks may contribute to preoperative anxiety. Future research should refine video content, assess long-term outcomes, and explore strategies to balance comprehension with emotional reassurance.