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Should obesity be associated with worse urinary continence outcomes after robotic-assisted radical prostatectomy? a propensity score matching analysis
Mourão, Thiago Camelo; Oliveira, Renato Almeida Rosa de; Favaretto, Ricardo de Lima; Santana, Thiago Borges Marques; Sacomani, Carlos Alberto Ricetto; Bachega Jr, Wilson; Guimarães, Gustavo Cardoso; Zequi, Stênio de Cássio.
  • Mourão, Thiago Camelo; Hospital da Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Oliveira, Renato Almeida Rosa de; Hospital da Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Favaretto, Ricardo de Lima; Hospital da Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Santana, Thiago Borges Marques; Hospital da Beneficência Portuguesa de São Paulo. Departamento de Uro-Oncologia. São Paulo. BR
  • Sacomani, Carlos Alberto Ricetto; AC Camargo Cancer Center. Divisão de Urologia. São Paulo. BR
  • Bachega Jr, Wilson; AC Camargo Cancer Center. Divisão de Urologia. São Paulo. BR
  • Guimarães, Gustavo Cardoso; Hospital da Beneficência Portuguesa. Departamento de Oncologia Cirúrgica. São Paulo. BR
  • Zequi, Stênio de Cássio; AC Camargo Cancer Center. Divisão de Urologia. São Paulo. BR
Int. braz. j. urol ; 48(1): 122-130, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1356274
Responsible library: BR1.1
ABSTRACT
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 11 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.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Obesity, Morbid / Robotic Surgical Procedures Type of study: Risk factors Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: AC Camargo Cancer Center/BR / Hospital da Beneficência Portuguesa de São Paulo/BR / Hospital da Beneficência Portuguesa/BR

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Obesity, Morbid / Robotic Surgical Procedures Type of study: Risk factors Limits: Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2022 Type: Article Affiliation country: Brazil Institution/Affiliation country: AC Camargo Cancer Center/BR / Hospital da Beneficência Portuguesa de São Paulo/BR / Hospital da Beneficência Portuguesa/BR