Agochukwu-Mmonu and colleagues report surgeon-level variation in sexual function outcomes over a 2-year period among men undergoing radical prostatectomy. In a selected group of patients with good baseline function, they show substantial variation in outcomes achieved. Some surgeons had up to 40% of patients recover sexual function while others had none.1
The foundation of this study is remarkable. Through the Michigan Urological Surgery Improvement Collaborative (MUSIC), the authors examine the effects of individual surgeons on sexual function and recovery. It remains quite rare for surgeons to permit such detailed information about outcomes tied to surgical skill to be compared to others. This speaks to the incredible trust cultivated among members of MUSIC and serves as a model for transformative surgical collaborations. Nevertheless, the study also raises important issues.