title: Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Multicenter Italian Report on Radical Prostatectomy (MIRROR) study.
abstract: OBJECTIVE
  This study aimed to evaluate the impact of abdominal obesity on preoperative features, complications and functional outcomes of men treated with radical prostatectomy (RP) for prostate cancer.
  
  
  METHODS
  In 2006 a multicentre Italian report on RP evaluated the surgical and functional characteristics of prostate cancer and RP outcomes. Age and waist circumference (WC) were recorded. Abdominal obesity was defined as a WC of at least 102 cm. International Index of Erectile Function (IIEF) score, prostate-specific antigen, prostate volume, tumour characteristics, presence/absence of perioperative complications and the number of blood units transfused were recorded. Preoperative and postoperative continence status was evaluated. Spearman correlation coefficient and binary logistic regression analyses were conducted.
  
  
  RESULTS
  In total, 470 men were recruited. A significant negative correlation between WC and preoperative IIEF scores was observed (r = -0.032, p < 0.001). Non-obese patients presented a preoperative IIEF score of 18.8 ± 6.0 and obese patients an IIEF score of 16.0 ± 7.0 (p < 0.001). Obese men are at three-fold greater risk of intraoperative complications and blood transfusions than those with a WC below 102 cm [adjusted odds ratio (OR) = 3.116, 95% confidence interval (CI) 0.281-16.348, p < 0.001, and OR = 2.763, 95% CI 0.518-3.843, p < 0.050, respectively]. A significant positive correlation between WC and postprostatectomy incontinence severity was observed. The risk of needing at least two pads per day is two and a half times greater in men with a WC of at least 102 cm than in those with a WC below 102 cm (adjusted OR = 2.435, 95% CI 0.321-7.668, p = 0.007).
  
  
  CONCLUSIONS
  Abdominal obesity in a multicentre Italian cohort of patients treated with RP was associated with an increased risk of intraoperative and perioperative complications and with a worse functional outcome.
authors.affiliation: Department of Urology, University of Florence, Careggi Hospital , Florence , Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Sebastianelli
authors.forename: Matteo
authors.initials: M
authors.lastname: Salvi
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Alchiede
authors.initials: A
authors.lastname: Simonato
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Mirone
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Carmignani
mesh_terms: D000368:Aged; D007172:Erectile Dysfunction / Q000453:epidemiology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology; D055105:Waist Circumference