Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

IMPACT OF OBESITY ON PERI-OPERATIVE AND LONG-TERM FUNCTIONAL OUTCOMES AFTER ROBOTIC ASSISTED SIMPLE PROSTATECTOMY

Alfredo Maria Bove
* ORCID logo ,
Mario Alberto Ochoa Arvizo
,
Aldo Brassetti
,
Simone D'Annunzio
,
Leonardo Misuraca
,
Gabriele Tuderti
,
Umberto Anceschi
,
Riccardo Mastroianni
,
Maria Consiglia Ferriero
,
Rocco Simone Flammia
,
Flavia Proietti
,
Costantino Leonardo
,
Giuseppe Simone
Version 1 : Received: 8 August 2023 / Approved: 8 August 2023 / Online: 9 August 2023 (10:53:31 CEST)

A peer-reviewed article of this Preprint also exists.

Bove, A.M.; Brassetti, A.; Anceschi, U.; Tuderti, G.; Misuraca, L.; Mastroianni, R.; Ferriero, M.; Simone, G. Impact of Obesity on Peri-Operative and Long-Term Functional Outcomes after Robotic Assisted Simple Prostatectomy. European Urology 2022, 81, S1308–S1309, doi:10.1016/s0302-2838(22)00963-0. Bove, A.M.; Brassetti, A.; Anceschi, U.; Tuderti, G.; Misuraca, L.; Mastroianni, R.; Ferriero, M.; Simone, G. Impact of Obesity on Peri-Operative and Long-Term Functional Outcomes after Robotic Assisted Simple Prostatectomy. European Urology 2022, 81, S1308–S1309, doi:10.1016/s0302-2838(22)00963-0.

Abstract

Obesity represents a worldwide epidemic disorder, increasing the overall morbidity and mortality rate. In this study we investigated the impact of obesity on peri-operative and long-term functional outcomes of Robotic assisted simple prostatectomy (RASP). Baseline flowmetry parameters and validated questionnaires’ scores were prospectively recorded. Follow-up assessments included Flowmetry and validated questionnaires. Composite outcomes (Trifecta) was defined as combination of: post-operative Q-max>15 ml/sec, IPSS score<8 and absence of complications. Pentafecta included also post-operative ejaculation persistence (MSHQ score>0) and the Erectile function maintenance (∆IEEF<6). Data were stratified by BMI (<30 or ≥30). 81 patients underwent RASP in our Institution. Baseline demographics and clinical features, questionnaires score and baseline flowmetry results were comparable between obese and non-obese cohorts. At follow-up, obese patients reported lower subjective improvement in IPSS (p=0.02) and OABQ scores (p<0.001) and higher incidence of stress incontinence requiring Duloxetin (p<0.001). Flowmetry outcomes, were also worse in this cohort (p=0.02 and p=0.03, respectively). At comprehensive outcomes assessment, obese patients had comparable Trifecta (67% vs 54%, p=0.39) and pentafecta achievement rate (p=0.76). Our prelimirary results proved that obesity is associated with worse functional outcomes (storage LUTS and incontinence rate) after RASP, but doesn’t affect trifecta and pentafecta achievement rate.

Keywords

robot-assisted simple prostatectomy, Obesity, BMI, benign prostatic obstruction, functional outcomes, Trifecta, pentafecta.

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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