The Effect of Body Mass Index On The Outcomes of Open Simple Prostatectomy

INTRODUCTION: Simple prostatectomy remains the gold standard treatment for patients with severe lower urinary tract symptoms(LUTS) and patients with enlarged prostate. Obesity, defined as a body mass index over 30kg/m2 by the World Health Organization(WHO), is associated with some perioperative complications. This study aims to investigate the effects of obesity on the outcomes of open simple prostatectomy.
METHODS: The study includes 72 patients that underwent open simple prostatectomy. We compared the treatment outcomes of 49 patients with a body mass index (BMI)<30kg/m2 and 16 patients with a BMI>30kg/m2. We compared the two groups in terms of change in International Prostate Symptom Score(IPSS), change in uroflowmetry maximum flow rate(Qmax), operation time, intraoperative blood loss, transfusion requirements.
RESULTS: The median of change in IPSS scores was 16(11-30) for the group where BMI<30kg/m2 and 15.5(10-20) for the group where BMI>30kg/m2. This difference was not statistically significant(p = 0.383). The mean duration of operation was 90.61±17.45 minutes for patients with BMI<30kg/m2 and 121.87±18.78 minutes for patients with a BMI>30kg/m2. The difference between the two groups was statistically significant(p<0.001). The median of blood loss was 450(200-700)cc for the BMI<30kg/m2 group and 725(550-850)cc for the BMI>30kg/m2 group, and this difference was statistically significant(p<0.001). However, the blood transfusion requirements of the two groups were statistically similar(p = 0.885).
DISCUSSION AND CONCLUSION: Open simple prostatectomy is very important technic in the treatment of BPH patients with enlarged prostates. Despite obesity is associated with a prolonged operation and increased transfusion rates in open simple prostatectomy, it can still be considered a safe treatment method.