Impact of Obesity on Surgical Outcomes following Open Radical Prostatectomy

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Abstract
Objective: The increasing incidence of both obesity and prostate cancer (PCa) detection will confront the urologist more often with obese men having PCa. It is unknown whether obesity affects the surgical and oncological outcomes following open radical retropubic prostatectomy (RRP). Knowledge concerning this issue is relevant when counselling obese patients with PCa for RRP. Patients and Methods: A single institution cohort study was performed including 252 men who underwent a RRP between 1992 and 2003. The surgical complications (perioperative complications, post-RRP urinary incontinence, urethral strictures) were compared between obese (BMI >30) and nonobese (BMI ≤30) men. Results: Compared to nonobese (n = 221), obese men (n = 31) developed more frequently wound infections (16.1 vs. 4.5%; p < 0.05), urinary incontinence (25.8 vs. 8.7%; p < 0.05) as well as vesico-urethral strictures (46.2 vs. 12.3%; p < 0.05). The pathology results and the 5-year cumulative risk of PSA recurrence were comparable among both groups. Conclusions: Compared to nonobese, obese men suffer more frequently from post-RRP urinary incontinence and vesicourethral strictures following open RRP.

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