title: Obesity does not adversely affect health-related quality-of-life outcomes after anatomic retropubic radical prostatectomy.
abstract: OBJECTIVE
  To study the impact of obesity on the health-related quality-of-life (HRQOL) outcomes after radical prostatectomy (RP).
  
  
  METHODS
  Patient-reported sexual and urinary HRQOL was assessed at baseline and 3, 6, 12, and 24 months after anatomic retropubic RP using the University of California, Los Angeles, Prostate Cancer Index among a cohort of 340 men. Linear regression analysis was used to compare the longitudinal HRQOL scores by body mass index (BMI) adjusting for age, baseline HRQOL, and nerve-sparing status (non-nerve sparing versus unilateral versus bilateral).
  
  
  RESULTS
  At baseline, the sexual and urinary function and bother scores were similar between normal-weight (BMI less than 25 kg/m2), overweight (BMI 25.0 to 29.9 kg/m2), and obese (BMI 30 kg/m2 or greater) men. Obese men were as likely to undergo bilateral nerve-sparing surgery as men with a lower BMI. After adjustment for age, baseline HRQOL, and nerve-sparing status, no statistically significant differences were found in any HRQOL score at any point among the BMI groups, except for a lower urinary function score at 24 months among overweight men (P = 0.02).
  
  
  CONCLUSIONS
  In a select group of men undergoing RP at a tertiary care referral center, BMI was, in general, unrelated to the baseline and longitudinal postoperative HRQOL scores. Obese men (BMI 30 to 35 kg/m2) should not be selectively discouraged against RP because of concerns about HRQOL. Additional studies are needed to assess the HRQOL outcomes among men with very high BMI values (greater than 35 kg/m2).
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-2101, USA. sfreedl1@jhmi.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
authors.forename: Michael C
authors.initials: MC
authors.lastname: Haffner
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Landis
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Saigal
authors.forename: H Ballentine
authors.initials: HB
authors.lastname: Carter
mesh_terms: D015992:Body Mass Index; D007172:Erectile Dysfunction / Q000209:etiology*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D011468:Prostatectomy / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000150:complications / Q000601:surgery; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology*