Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy.
OBJECTIVE
To determine the influence of body weight and prostate volume on surgical outcomes after radical retropubic prostatectomy.


METHODS
Between January 1994 and July 2000, 1024 men underwent radical retropubic prostatectomy by a single surgeon. Information was collected on body weight, prostate volume, operative time, estimated blood loss, allogenic transfusion rate, intraoperative complications, perioperative complications, postoperative complications, surgical margin status, and length of hospital stay. Postoperative continence and erectile function were assessed from self-administered questionnaires.


RESULTS
Body weight was not significantly related to operative time (P = 0.09), estimated blood loss (P = 0.12), allogenic transfusion rate (P = 0.49), intraoperative complications (P = 0.37), perioperative complications (P = 0.84), postoperative complications (P = 0.44), positive margin rate (P = 0.07), length of hospital stay (P = 0.27), postoperative continence (P = 0.72), or postoperative erectile function (P = 0.92). The prostate volume was significantly and directly related to the estimated blood loss (P = 0.02), allogenic transfusion rate (P = 0.01), and length of hospital stay (P = 0.01). The prostate volume was significantly and inversely related to the positive surgical margin rate (P = 0.03). The prostate volume was not significantly related to the operative time (P = 0.12), intraoperative complications (P = 0.68), perioperative complications (P = 0.73), postoperative complications (P = 0.14), postoperative continence (P = 0.23), or postoperative erectile function (P = 0.90).


CONCLUSIONS
No clinically relevant risks were associated with increasing body weight. Intraoperative bleeding resulting in higher transfusion rates represented the only clinically significant outcome that was adversely impacted by prostate volume. In the hands of experienced surgeons, radical retropubic prostatectomy can be performed in heavy men and in men with large prostates with excellent outcomes.
Hsu
Elias I
EI
Department of Urology, New York University School of Medicine, New York, New York 10016, USA.
Hong
Eugene K
EK
Lepor
Herbert
H
D000368:Aged; D001835:Body Weight; D007172:Erectile Dysfunction / Q000175:diagnosis / Q000453:epidemiology; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D011467:Prostate / Q000473:pathology*; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology