Visceral adiposity is associated with worse urinary and sexual function recovery after radical prostatectomy: Results from a longitudinal cohort study

• Main Authors: Tommaso Cai, Andrea Cocci, Fabrizio Di Maida, Stefano Chiodini, Francesco Ciarleglio, Lorenzo Giuseppe Luciani, Giovanni Pedrotti, Alessandro Palmieri, Gianni Malossini, Michele Rizzo, Giovanni Liguori, Truls E. Bjerklund Johansen
• Format: Article
• Language: English
• Published: PAGEPress Publications 2021-09-01
• Series: Archivio Italiano di Urologia e Andrologia
• Subjects: Prostate cancer; Adiposity; Metabolic syndrome; Body mass index; Quality of life
• Online Access: https://www.pagepressjournals.org/index.php/aiua/article/view/9860

Objective: A prospective longitudinal cohort study on the impact of anthropometric measures on the sexual function and continence recovery in patients treated with laparoscopic radical prostatectomy (LRP) is presented. Material and methods: Anthropometric measures, International Index of Erectile Function (IIEF-5) and International Prostatic Symptoms Score questionnaires, were collected before surgery and at the end of follow-up period. All patients were assigned into the following groups: A) non-obese; B) non-obese with central adiposity; C) obese without central adiposity; D) obese with central adiposity. Urinary and sexual functions were the outcome measures. Results: At the end of follow-up, in 29 patients with visceral adiposity (VA) the median IIEF-5 was 14 (IQR 7-18) while in 49 non-VA patients (62.8%) was 22 (IQR 17-24) (p < 0.001). Twenty-three patients (79.3%) with VA reported complete continence, while 6 (20.7%) used ≥ 2 pads per day. Forty-eight patients (97.9%) without VA reported complete continence. VA was confirmed as a strong independent predictor for worse continence (HR 3.67; 2.75-4.51 CI95% p = 0.003) and sexual function recovery (HR: 4.51; 3.09-5.63 CI95% p < 0.001). Conclusion: We truly believe obese with visceral adiposity patients with prostate cancer should receive detailed preoperative counseling before surgery, including higher risk of suboptimal functional outcomes.