Weight status influences urinary function recovery after radical prostatectomy

Among prostate cancer patients, those without obesity are more likely to experience earlier recovery in urinary function after radical prostatectomy and have better sexual function both before and after the procedure, as reported in a study.

The Prostatectomy, Incontinence and Erectile dysfunction study included 407 patients who had undergone radical prostatectomy for clinically localized prostate cancer. Baseline measurements, such as height and weight, were obtained. Urinary and sexual function were assessed using the modified Expanded Prostate Cancer Index Composite-50, which was taken at baseline and at week 5, month 6, and month 12 after the surgical procedure.

More than half of the patients (68.8 percent) had no obesity. This group had similar preprocedure urinary function (p=0.217) but had better preprocedure sexual function (p=0.006) relative to the group of patients with obesity.

One year after surgery, urinary and sexual function returned to baseline levels in 50.5 percent and 28.9 percent of patients, respectively. Recovery was not, however, uniform by obesity.

Compared to the obese group, the nonobese group had significantly better urinary function at the 6- (p<0.001) and 12-month (p=0.011) follow-up and was more likely to experience recovery by the 6-month assessment (odds ratio, 2.55, 95 percent confidence interval [CI], 1.36–4.76).

For sexual function, the nonobese group had better functioning at the 6- (p=0.028) and 12-month (p=0.051) assessments but had a similar likelihood of recovery 1-year after the surgical procedure.

The findings support tailored counselling about the side effects of radical prostatectomy and prehabilitation treatment to improve these side-effects.