PE patients worldwide struggle with the decision to pursue surgical treatment. Different physicians may give different recommendations, and there is not currently widespread agreement on which inclusion/exclusion criteria should be used for surgical candidacy. In this international, multicenter study, PE patients completed questionnaires related to the surgical decision-making process. Overall, patients were interested in formal help with this decision-making process. Under the model proposed here, a psychosocial counselor would be included as part of the healthcare team evaluating whether an individual with PE is eligible for surgery. Their role would be to help the patient synthesize information from multiple healthcare providers and explore how PE surgery may impact their life, with physical and psychosocial considerations in mind. Future studies should test this model and evaluate whether it aids the decision-making process.