Impact of Obesity on Clinical Presentation and Surgical Outcomes in Patients with Benign Prostate Hyperplasia Receiving Greenlight Laser Prostatectomy

Objective: To investigate the impact of body mass index (BMI) on preoperative characteristics, lower urinary tract symptoms (LUTS), intraoperative variables, surgical outcomes and postoperative complications.

Methods: This is a retrospective observational study including 891 benign prostate hyperplasia (BPH) patients who underwent GreenLight Laser photoselective vaporization of the prostate (PVP) between 2014 and 2020. Clinical characteristics, uroflowmetry parameters, and surgery related parameters were extracted from electronic health records. Patients were categorized into different weight groups based on Taiwanese populations' BMI criteria. Statistical analyses, involving descriptive statistics, correlation analyses, and independent t-tests, were employed to examine associations between BMI and relevant variables.

Results: Pearson's correlation analysis indicated a negative correlation between BMI (r = -0.172, p < 0.001) and age, and positive correlations with total prostate volume (TPV) (r = 0.123, p < 0.001) and transition zone volume (TZV) (r = 0.083, p = 0.017). Obese patients were found to be younger (p=0.007) and have larger TPVs (p=0.010) but showed no significant differences in International Prostate Symptom Scores (IPSS) scores when compared to non-obese patients. Notably, obese patients had lower preoperative and postoperative post-void residual (PVR), whereas non-obese patients exhibited a more significant PVR reduction post-surgery. BMI did not significantly affect surgical parameters or postoperative complications.

Conclusion: In BPH patients treated with PVP, obese individuals were younger with larger prostates but had similar IPSS scores compared to non-obese patients. Obese patients had lower pre and post-surgery PVR, while non-obese patients saw greater PVR improvements. BMI plays a nuanced role BPH patients' characteristics.