Body Mass Index Predicts Failure of Surgical Management in Benign Prostatic Hyperplasia

Abstract

Introduction: Inflammation is postulated to link obesity and benign prostatic hyperplasia (BPH). The role of inflammation and the prognostic significance of body mass index (BMI) was investigated in BPH patients. Subjects and Methods: Consecutive patients with histological BPH were identified from 1996 to 2005. Systemic inflammation was assessed by modified Glasgow Prognostic Score (mGPS) and local inflammation by Klintrup-Makinen criteria. Results: In 392 patients, BMI was associated with cardiovascular disease (p = 0.033), type 2 diabetes mellitus (p = 4.45 × 10^-8), aspirin usage (p = 0.018) and failure of surgical treatment (p = 0.001). mGPS and Klintrup-Makinen scores were not associated with clinical variables or outcome measures. On multivariate analysis BMI was an independent predictor of time to failure of surgical management of BPH, HR 1.56 (95% CI 1.11-2.19), p = 0.010. Conclusions: The mGPS and Klintrup-Makinen scores were not associated with BMI in BPH patients. High BMI is associated with failure of surgical management of BPH. Preoperative weight loss should be strongly encouraged in these patients.

Effects of Medical Therapy or Surgery on Prostatic and Bladder Resistive Indices in Patients with Benign Prostatic Hyperplasia

“…Smoking and other vascular risk factors such as hypertension were also found to be associated with LUTS [23]. Increased local/systemic inflammation, tissue necrosis, and high BMI were the other factors that were suspected to cause LUTS and affect the success of BPH treatment in recent studies [24,25]. …”

Laser Therapy for Bladder Outlet Obstruction: A Prospective Analysis of All Patients Receiving Treatment with the GreenLight XPS 180-Watt Laser System after Introduction at a Single Center

“…Other causes of bladder outlet obstruction are malignant diseases of the prostate, bladder neck sclerosis following resection of the prostate or strictures following radical prostatectomy. Transurethral resection of the prostate (TURP) or transurethral resection of the bladder neck remain the gold standard, but have questionable safety profiles [1,2]. Large prostate volumes, in particular, frequently lead to bleeding complications [3].…”

Willder JM, Walker VC, Halbert GL, et al: Body Mass Index Predicts Failure of Surgical Management in Benign Prostatic Hyperplasia. Urol Int 2013;90:150-155

“…We congratulate the authors [1] as they very well infer the results that high body mass index (BMI) is associated with failure of surgical management of BPH. …”