OBJECTIVES: To evaluate the impact of body mass index (BMI) on outcome after orthotopic neobladder (NB) reconstruction. METHODS: We performed a retrospective analysis of patients who underwent radical cystectomy and NB from 1992 to 2004. The patients were categorized according to BMI into group 1, BMI less than 25 kg/m2; group 2, BMI 25 to 29.9 kg/m2; and group 3, BMI greater than 30 kg/m2. The relationships among the BMI categories, the predominant complications (eg, urinary tract infection [UTI]; pyelonephritis; ureteral, bladder neck, and urethral stricture), other complications, and continence were analyzed. RESULTS: Of the 343 patients who underwent radical cystectomy, 116 had an NB. The patient characteristics among the BMI groups were similar. Group 1 had fewer complications compared with the other groups (P <0.012). The principal complications observed were UTI, stricture, and pyelonephritis. The incidence of UTI, pyelonephritis, and wound infection were less in group 1 than in the other groups, with statistically significant differences (P = 0.001, P = 0.04, and P = 0.04, respectively). At the last follow-up visit, only 10% of the patients required clean intermittent catheterization to empty the NB, and no statistically significant differences were found in the continence status and voiding pattern among the groups. CONCLUSIONS: An increased incidence of UTI, pyelonephritis, and wound infection was found in patients with increased BMI. However, they were transient and not life threatening. The continence and voiding patterns were relatively similar. Hence, an NB can be offered to patients with an increased BMI, and they should be formally counseled.
OBJECTIVES: To evaluate the impact of body mass index (BMI) on outcome after orthotopic neobladder (NB) reconstruction. METHODS: We performed a retrospective analysis of patients who underwent radical cystectomy and NB from 1992 to 2004. The patients were categorized according to BMI into group 1, BMI less than 25 kg/m2; group 2, BMI 25 to 29.9 kg/m2; and group 3, BMI greater than 30 kg/m2. The relationships among the BMI categories, the predominant complications (eg, urinary tract infection [UTI]; pyelonephritis; ureteral, bladder neck, and urethral stricture), other complications, and continence were analyzed. RESULTS: Of the 343 patients who underwent radical cystectomy, 116 had an NB. The patient characteristics among the BMI groups were similar. Group 1 had fewer complications compared with the other groups (P <0.012). The principal complications observed were UTI, stricture, and pyelonephritis. The incidence of UTI, pyelonephritis, and wound infection were less in group 1 than in the other groups, with statistically significant differences (P = 0.001, P = 0.04, and P = 0.04, respectively). At the last follow-up visit, only 10% of the patients required clean intermittent catheterization to empty the NB, and no statistically significant differences were found in the continence status and voiding pattern among the groups. CONCLUSIONS: An increased incidence of UTI, pyelonephritis, and wound infection was found in patients with increased BMI. However, they were transient and not life threatening. The continence and voiding patterns were relatively similar. Hence, an NB can be offered to patients with an increased BMI, and they should be formally counseled.
Authors: Thomas G Clifford; Behrod Katebian; Christine M Van Horn; Soroush T Bazargani; Jie Cai; Gus Miranda; Siamak Daneshmand; Hooman Djaladat Journal: World J Urol Date: 2018-01-25 Impact factor: 4.226
Authors: Ali Al-Daghmin; Eric C Kauffman; Yi Shi; Ketan Badani; M Derya Balbay; Erdem Canda; Prokar Dasgupta; Reza Ghavamian; Robert Grubb; Ashok Hemal; Jihad Kaouk; Adam S Kibel; Thomas Maatman; Mani Menon; Alex Mottrie; Kenneth Nepple; John G Pattaras; James O Peabody; Vassilis Poulakis; Raj Pruthi; Juan Palou Redorta; Koon-Ho Rha; Lee Richstone; Francis Schanne; Douglas S Scherr; Stefan Siemer; Michael Stöckle; Eric M Wallen; Alon Weizer; Peter Wiklund; Timothy Wilson; Gregory Wilding; Michael Woods; Khurshid A Guru Journal: BJU Int Date: 2014-05-22 Impact factor: 5.588