Should obesity be associated with worse urinary continence outcomes after robotic-assisted radical prostatectomy? a propensity score matching analysis
Autor: | Thiago Camelo Mourão, Renato Almeida Rosa de Oliveira, Ricardo de Lima Favaretto, Thiago Borges Marques Santana, Carlos Alberto Ricetto Sacomani, Wilson Bachega Jr., Gustavo Cardoso Guimarães, Stênio de Cássio Zequi |
---|---|
Jazyk: | angličtina |
Rok vydání: | 2022 |
Předmět: | |
Zdroj: | International Brazilian Journal of Urology, Vol 48, Iss 1, Pp 122-130 (2022) |
Druh dokumentu: | article |
ISSN: | 1677-6119 1677-5538 46009736 |
DOI: | 10.1590/s1677-5538.ibju.2021.0457 |
Popis: | ABSTRACT Purpose: To analyze the association between obesity and urinary incontinence rate in men submitted to robot-assisted radical prostatectomy (RARP) in a high-volume cancer center. Materials and Methods: We reported 1.077 men who underwent RARP as the primary treatment for localized prostate cancer from 2013 to 2017. Patients were classified as non-obese (normal BMI or overweight) or obese men (BMI ≥30kg/m2). They were grouped according to the age, PSA level, D’Amico risk group, Gleason score, ASA classification, pathological stage, prostate volume, salvage/adjuvant radiotherapy, perioperative complications, and follow-up time. Urinary continence was defined as the use of no pads. For the analysis of long-term urinary continence recovery, we conducted a 1:1 propensity-score matching to control confounders. Results: Among the obese patients, mean BMI was 32.8kg/m2, ranging 30 - 45.7kg/m2. Only 2% was morbidly obese. Obese presented more comorbidities and larger prostates. Median follow-up time was 15 months for the obese. Complications classified as Clavien ≥3 were reported in 5.6% of the obese and in 4.4% of the non-obese men (p=0.423). Median time for continence recovery was 4 months in both groups. In this analysis, HR was 0.989 for urinary continence recovery in obese (95%CI=0.789 - 1.240; p=0.927). Conclusions: Obese can safely undergo RARP with similar continence outcomes comparing to the non-obese men when performed by surgeons with a standardized operative technique. Future studies should perform a subgroup analysis regarding the association of obesity with other comorbidities, intending to optimize patient counseling. |
Databáze: | Directory of Open Access Journals |
Externí odkaz: |