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Early Post-Operative Events After Urethroplasty in Obese Patients: A Multi-Institutional Retrospective Series
J Patrick Mershon1, Janine Bennett1, Matthew Murtha1
1Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH.
Urology
|May 16, 2024
Summary
Obesity does not negatively impact urethroplasty outcomes for urethral stricture disease. This study found that while obese patients experienced more blood loss and longer hospital stays, complication rates and recurrence were similar to non-obese individuals.
Area of Science:
- Urology
- Surgical Outcomes
- Obesity Medicine
Background:
- Urethral stricture disease affects a significant patient population.
- The rising prevalence of obesity presents challenges in surgical management.
- The impact of varying degrees of obesity on urethroplasty outcomes remains incompletely understood.
Purpose of the Study:
- To compare early urethroplasty outcomes between non-obese, obese, and morbidly obese patients.
- To investigate the influence of obesity on complication rates, recurrence, and need for secondary interventions following urethroplasty.
- To assess the safety and efficacy of urethroplasty in the context of increasing obesity rates.
Main Methods:
- A comparative study involving 201 patients undergoing urethroplasty across five institutions from January 2016 to December 2020.
- Patients were categorized into normal weight (BMI <25), overweight (BMI 25-29.9), obese (BMI 30-39.9), and morbidly obese (BMI >40) groups.
- Data collected included demographics, comorbidities, stricture characteristics, and outcomes such as complications, recurrence, and secondary interventions, analyzed using univariate and multivariate methods.
Main Results:
- Obese patients were younger and presented with more anterior, iatrogenic, and LS-associated strictures.
- The overall 60-day complication rate was 26.3% with no significant difference between weight cohorts.
- Obese patients experienced greater estimated blood loss and longer hospital stays, but obesity was not associated with contrast leak, recurrence, or need for additional interventions.
Conclusions:
- Urethroplasty is a safe and effective procedure for obese patients with urethral stricture disease.
- While obese patients may have specific stricture types and increased intraoperative blood loss/length of stay, their overall surgical outcomes are comparable.
- These findings support the continued use of urethroplasty in managing urethral strictures irrespective of patient weight category.
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