Impact of Body Mass Index on Outcomes following Anatomic GreenLight Laser Photoselective Vaporization of the Prostate

Hudson Pierce, Ramy Goueli, Bashir Al Hussein Al Awamlh, Shokhi Goel, Malek Meskawi, Kevin Zorn, Alexis Te, Bilal Chughtai

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction: Obesity can lead to increased risk of perioperative complications in surgical patients, but evidence is lacking regarding the impact of obesity on bladder outlet surgery outcomes. We sought to assess the safety and efficacy of GreenLight photoselective vaporization of the prostate (PVP) in obese patients by comparing functional outcomes and complications in men, stratified according to the body mass index (BMI). Materials and Methods: A retrospective analysis was undertaken of 424 men who underwent 180W GreenLight PVP between 2012 and 2016 at two tertiary medical centers. Patients were stratified based on the World Health Organization (WHO) classification of obesity as determined by BMI. Normal weight men had BMI <25 kg/m2, overweight men had BMI between 25 and 30 kg/m2, and obese men had BMI greater than 30 kg/m2. Primary endpoints examined were differences in intraoperative outcomes and incidence of intraoperative and postoperative complications between BMI groups. Secondary endpoints were improvements in the International Prostate Symptom Score, quality of life score, and the uroflowmetry variables, maximum urinary flow rate and postvoid residual. Results: The BMI groups did not differ regarding operative time or lasing time after matching for prostate volume, but overweight patients in the matched cohort still required higher mean energy use than normal weight men (258.6 kJ vs 233.9 kJ; p = 0.017). No significant differences between BMI groups were observed for intraoperative complications, postoperative complications, or readmission rates. All functional parameters were significantly improved at 24 months for each group, with no differences in improvement between groups. On multivariable analysis, BMI was not a significant predictor for outcomes following PVP. Conclusions: Increased BMI has a negligible effect on intraoperative parameters and does not affect postoperative complication rates or functional outcomes. GreenLight XPS 180W PVP is a safe and effective procedure in overweight and obese men.

Original languageEnglish (US)
Pages (from-to)39-45
Number of pages7
JournalJournal of endourology
Volume35
Issue number1
DOIs
StatePublished - Jan 2021
Externally publishedYes

Keywords

  • benign prostatic hyperplasia
  • body mass index
  • GreenLight
  • laser
  • photoselective vaporization of the prostate
  • prostate

ASJC Scopus subject areas

  • Urology

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