title: Central obesity is predictive of persistent storage lower urinary tract symptoms (LUTS) after surgery for benign prostatic enlargement: results of a multicentre prospective study.
abstract: OBJECTIVE
  To evaluate the impact of components of metabolic syndrome (MetS) on urinary outcomes after surgery for severe lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE), as central obesity can be associated with the development of BPE and with the worsening of LUTS.
  
  
  METHODS
  A multicentre prospective study was conducted including 378 consecutive men surgically treated for large BPE with simple open prostatectomy (OP) or transurethral resection of the prostate (TURP), between January 2012 and October 2013. LUTS were measured by the International Prostate Symptom Score (IPSS), immediately before surgery and at 6-12 months postoperatively. MetS was defined according the USA National Cholesterol Education Program-Adult Treatment Panel III.
  
  
  RESULTS
  The improvement of total and storage IPSS postoperatively was related to diastolic blood pressure and waist circumference (WC). A WC of >102 cm was associated with a higher risk of an incomplete recovery of both total IPSS (odds ratio [OR] 0.343, P = 0.001) and storage IPSS (OR 0.208, P < 0.001), as compared with a WC of <102 cm. The main limitations were: (i) population selected from a tertiary centre, (ii) Use exclusively of IPSS questionnaire, and (iii) No inclusion of further data.
  
  
  CONCLUSIONS
  Increased WC is associated with persistent postoperative urinary symptoms after surgical treatment of BPE. Obese men have a higher risk of persistent storage LUTS after TURP or OP.
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Gacci
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Sebastianelli
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Salvi
authors.affiliation: Department of Urology, Sant'Andrea Hospital, University 'La Sapienza', Rome, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: De Nunzio
authors.affiliation: Department of Urology, Sant'Andrea Hospital, University 'La Sapienza', Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Tubaro
authors.affiliation: Department of Clinical Physiopathology, University of Florence, Florence, Italy.
authors.forename: Linda
authors.initials: L
authors.lastname: Vignozzi
authors.affiliation: Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.affiliation: Department of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: McVary
authors.affiliation: Department of Urology, Weill Cornell Medical College, Cornell University, New York, NY, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kaplan
authors.affiliation: Department of Clinical Physiopathology, University of Florence, Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Carini
authors.affiliation: Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Serni
mesh_terms: D000368:Aged; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000150:complications / Q000453:epidemiology*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D055105:Waist Circumference
keywords: benign prostatic enlargement; benign prostatic hyperplasia; lower urinary tract symptoms; metabolic syndrome; waist circumference