title: Does body mass index affect outcome after reconstruction of orthotopic neobladder?
abstract: OBJECTIVE
  To evaluate the impact of body mass index (BMI) on outcome after orthotopic neobladder (NB) reconstruction.
  
  
  METHODS
  We performed a retrospective analysis of patients who underwent radical cystectomy and NB from 1992 to 2004. The patients were categorized according to BMI into group 1, BMI less than 25 kg/m2; group 2, BMI 25 to 29.9 kg/m2; and group 3, BMI greater than 30 kg/m2. The relationships among the BMI categories, the predominant complications (eg, urinary tract infection [UTI]; pyelonephritis; ureteral, bladder neck, and urethral stricture), other complications, and continence were analyzed.
  
  
  RESULTS
  Of the 343 patients who underwent radical cystectomy, 116 had an NB. The patient characteristics among the BMI groups were similar. Group 1 had fewer complications compared with the other groups (P <0.012). The principal complications observed were UTI, stricture, and pyelonephritis. The incidence of UTI, pyelonephritis, and wound infection were less in group 1 than in the other groups, with statistically significant differences (P = 0.001, P = 0.04, and P = 0.04, respectively). At the last follow-up visit, only 10% of the patients required clean intermittent catheterization to empty the NB, and no statistically significant differences were found in the continence status and voiding pattern among the groups.
  
  
  CONCLUSIONS
  An increased incidence of UTI, pyelonephritis, and wound infection was found in patients with increased BMI. However, they were transient and not life threatening. The continence and voiding patterns were relatively similar. Hence, an NB can be offered to patients with an increased BMI, and they should be formally counseled.
authors: Department of Urology, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
authors: Martha A
authors: MA
authors: Reyes
authors: Alan M
authors: AM
authors: Nieder
authors: Bruce R
authors: BR
authors: Kava
authors: Mark S
authors: MS
authors: Soloway
authors: Murugesan
authors: M
authors: Manoharan
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015653:Cystectomy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011704:Pyelonephritis / Q000453:epidemiology; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion; D014552:Urinary Tract Infections / Q000453:epidemiology