Obese men quickly regain continence after lap RP

January 1, 2006

Amsterdam, Netherlands--An increased body mass index has been shown to confound the outcome of numerous surgical treatments. The effect of BMI on cardiovascular disease, insulin resistance, cancer mortality, and blood loss during radical surgery is well documented. Less clear is the effect of BMI on laparoscopic surgery, including laparoscopic radical prostatectomy.

Amsterdam, Netherlands-An increased body mass index has been shown to confound the outcome of numerous surgical treatments. The effect of BMI on cardiovascular disease, insulin resistance, cancer mortality, and blood loss during radical surgery is well documented. Less clear is the effect of BMI on laparoscopic surgery, including laparoscopic radical prostatectomy.

The researchers studied quality of life outcomes prospectively using the validated Expanded Prostate Cancer Index Composite (EPIC). EPIC scores were collected preoperatively and at 3, 6, and 12 months postoperatively. Functional outcomes were assessed using the urinary incontinence subscale and were reported as a percentage of baseline function.

Unexpected outcomes

Interestingly, contrary to published reports, overweight patients reported significantly better urinary continence at 3 and 6 months after laparoscopic radical prostatectomy than did the non-obese patients. However, at 12 months, both groups had achieved an equivalent return of continence. At 6 months, the effect was most pronounced, Dr. Link reported.

"Men with a BMI greater than 30 had even better continence outcomes than [did] moderately overweight (BMI 25 to 30) or non-obese men (BMI <25) at 6 months," he said.

The researchers concluded that overweight patients have a significantly earlier return of continence than do normal-weight controls following laparoscopic radical prostatectomy. These findings contradict data reported in open radical prostatectomy series showing worse continence outcomes in obese patients.

Thus, obesity does not appear to be a significant variable in predicting continence following laparoscopic radical prostatectomy. As long-term data from the various laparoscopic series are reported, the significance of these findings will become more evident.