Investig Clin Urol.  2017 Sep;58(5):331-338. 10.4111/icu.2017.58.5.331.

Patient-reported quality of life recovery curves after robotic prostatectomy are similar across body mass index categories

• Garg T
• Young AJ
• Kost KA
• Park AM
• Danella JF
• Kirchner H

• KMID: 2388049
• DOI: http://doi.org/10.4111/icu.2017.58.5.331

Abstract

PURPOSE
To assess the impact of body mass index (BMI) on postoperative recovery curve of urinary and sexual function after robotic-assisted laparoscopic prostatectomy (RALP). We hypothesized that overweight and obese men have different recovery curves than normal weight men.
MATERIALS AND METHODS
We reviewed preoperative and postoperative surveys from 691 men who underwent RALP from 2004-2014 in an integrated healthcare delivery system. Survey instruments included: sexual health inventory for men (SHIM), urinary behavior, leakage, and incontinence impact questionnaire (IIQ). A repeated measures analysis with autoregressive covariance structure was employed with linear splines with 2 knots for the time factor. We fit unadjusted and adjusted models and stratified by BMI (under/normal weight, overweight, and obese). Adjusted models included age, race/ethnicity, smoking status, diabetes, operation length, prostate-specific antigen, pathologic stage, nerve-sparing status, and surgery year.
RESULTS
Mean age was 59 years. Most men were overweight (43%) and obese (42%). There were no significant differences in mean baseline SHIM, urinary behavior, leakage, and IIQ scores by BMI category. All groups had initial steep declines in urinary and sexual function in the first 3 months after RALP. There were no significant differences in postoperative urinary and sexual function score curves by BMI category.
CONCLUSIONS
The pattern of urinary and sexual function recovery was similar across all BMI categories. Overweight and obese men may be counseled that urinary and sexual function recovery curves after surgery is similar to that of normal weight men.

Keyword

Obesity; Patient reported outcome measures; Prostatectomy; Quality of life

MeSH Terms

Body Mass Index*
Delivery of Health Care
Humans
Male
Obesity
Overweight
Prostate-Specific Antigen
Prostatectomy*
Quality of Life*
Recovery of Function
Reproductive Health
Smoke
Smoking
Time Factors
Prostate-Specific Antigen
Smoke

Figure

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  Fig. 1 Median body mass index (BMI) by year of robotic assisted laparoscopic prostatectomy (RALP).

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  Fig. 2 (A–D) Urinary and sexual function recovery curve after robotic-assisted laparoscopic prostatectomy (RALP) for an averaged patient in the cohort with 95% confidence intervals. SHIM, sexual health inventory for men; IIQ, incontinence impact questionnaire.

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  Fig. 3 (A–D) Urinary and sexual function recovery curves after robotic-assisted laparoscopic prostatectomy (RALP) stratified by body mass index (BMI) categories. SHIM, sexual health inventory for men; IIQ, incontinence impact questionnaire. BMI (kg/m2): normal, 18.5–24.9; overweight, 25–29.9; obese, >30.

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