Restoration of Continence after Prostatectomy is Associated With Weight Loss: A Pilot Study.

Abstract

OBJECTIVES:

To examine association between post-prostatectomy incontinence (PPI) severity and weight changes before and after restoration of continence via artificial urinary sphincter (AUS).

METHODS:

Single surgeon, retrospective review of urologic prosthetic surgery (UPS) after radical prostatectomy (RP). A cohort of post-RP inflatable penile prosthesis (IPP) patients served as a surgical control. Body Mass Index (BMI) and total body weight were assessed pre and post-UPS. Multivariable linear regression was utilized to assess BMI changes post-UPS.

RESULTS:

187 AUS and 63 IPP patients met selection criteria. Greater PPI severity was associated with faster BMI gain after RP (coeff. 0.14 kg/m2, P = 0.03, per pad used) and magnitude of incontinence improvement (mean reduction in daily pad use) after AUS insertion was associated with greater BMI reduction at 12 months post-UPS (coeff. - 0.13 kg/m2, P = 0.04). On multivariable regression, AUS insertion was associated with a decrease in BMI by - 2.83 kg/m2 12 months post-UPS (P = 0.02). Twelve months post-UPS, men with AUS exhibited a mean BMI reduction of -1.0 kg/m2 compared to a mean BMI increase in the IPP cohort of 0.4 kg/m2 (P < 0.01). Compared to IPP, AUS patients experienced absolute body weight reduction by 6 kg [Median(IQR): 90.4 (80.3-100.1) vs 96.4 (87.1-108.8) kg, P = 0.03], with nearly one-third having clinically significant weight loss (>5% body weight) at 12 months post-UPS (31.8% vs 8.3%, P < 0.01).

CONCLUSION:

Severe PPI appears to be associated with weight gain and correction of PPI via AUS insertion with weight loss.

• Authors: Raj R Bhanvadia, Benjamin M Dropkin, Avery R Wolfe, Linley Diao, Sarah C Sanders, Gregory A Joice, Claus G Roehrborn, Steven J Hudak, Allen F Morey
• Journal: Urology (Urology) Vol. 158 Pg. 162-168 (12 2021) ISSN: 1527-9995 [Electronic] United States
• PMID: 34469769 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Aged
• Body Mass Index
• Humans
• Middle Aged
• Pilot Projects
• Prostatectomy (adverse effects)
• Retrospective Studies
• Urinary Incontinence, Stress (etiology, surgery)
• Urinary Sphincter, Artificial
• Weight Loss