The Influence of Obesity on Clinical Manifestations and Surgical Results in Benign Prostate Hyperplasia Patients Undergoing GreenLight Laser Prostatectomy

肥胖對接受綠光雷射攝護腺汽化切除手術之良性攝護腺增生患者的臨床表現和手術結果之影響

Ruei-Je Chang¹†, Po-Han Chen³†, Hsiang-Shen Wang⁵, Ying-Hsu Chang^2,4, Chung-Yi Liu^2,4, Liang-Kang Huang^1,2, Hung-Chen Kan^1,2, Po-Hung Lin^1,2, Kai-Jie Yu^1,2, Cheng-Keng Chuang^1,2, See-Tong Pang^1,2, Chun-Te Wu^{1, 2}, Ming-Li Hsieh^1,2, I-Hung Shao^1,2*

張睿哲¹†, 諶柏翰³†, 王翔生⁵, 張英勛^2,4, 劉忠一^2,4, 黃亮鋼^1,2, 甘弘成^1,2, 林柏宏^1,2, 虞凱傑^1,2, 莊正鏗^1,2, 馮思中^1,2, 吳俊德^1,2, 謝明里^1,2, 邵翊紘^1,2*

¹Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou Branch, Taiwan

²Department of medicine, Chang Gung University, Taoyuan, Taiwan

³Medical foundation, Chang Gung Memorial Hospital, Linkou Branch, Taiwan

⁴Division of Urology, Department of Surgery, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, Taiwan

⁵Department of Pathology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan

†These authors contributed equally to this work

¹林口長庚紀念醫院外科部泌尿外科系

²長庚大學醫學院醫學系

³林口長庚紀念醫院教學部

⁴新北市立土城醫院外科部泌尿科

⁵林口長庚紀念醫院病理部

†共同第一作者

研究目的 (Purpose):

To investigate how body mass index (BMI) affects preoperative characteristics, lower urinary tract symptoms (LUTS), intraoperative variables, surgical outcomes, and postoperative complications.

材料與方法 (Materials and Methods):

This study included 891 patients with benign prostate hyperplasia (BPH) who had GreenLight Laser photoselective vaporization of the prostate (PVP) between 2014 and 2020. Information on clinical characteristics, uroflowmetry parameters, and surgical details was gathered from electronic health records. Patients were categorized by Taiwanese BMI standards. Statistical analyses, including descriptive statistics, correlations, and t-tests, were used to examine the connection between BMI and related factors.

結果 (Results):

BMI was negatively correlated with age (r = -0.172, p < 0.001) but positively correlated with total prostate volume (TPV) (r = 0.123, p < 0.001) and transition zone volume (TZV) (r = 0.083, p = 0.017) based on Pearson's correlation analysis. Among obese patients, there were associations with younger age (p = 0.007) and larger TPVs (p = 0.010), with no significant differences in International Prostate Symptom Scores (IPSS) compared to non-obese patients. Obese patients had lower preoperative and postoperative post-void residual (PVR) volumes, while non-obese patients experienced a more substantial reduction in PVR post-surgery. BMI did not significantly impact surgical parameters or postoperative complications.

結論 (Conclusions):

In BPH patients undergoing PVP, obese individuals were younger with larger prostates but had similar IPSS scores compared to non-obese patients. Obese patients had lower pre and post-surgery PVR, while non-obese patients saw greater PVR improvements. BMI has a nuanced impact on BPH patients' characteristics.