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Male Gender Is a Contributing Risk Factor to Predict Sticky Fat in Laparoscopic Partial Nephrectomy
Erkan Olcucuoglu1, Samet Senel1, Muhammed Emin Polat1
1Department of Urology, Ankara Bilkent City Hospital, Ankara 06100, Türkiye.
Objective:
This study aimed to identify predictive factors for adherent perinephric fat (APF), or sticky fat, in patients undergoing laparoscopic partial nephrectomy (LPN), with particular emphasis on evaluating male gender as an independent risk factor beyond the Mayo Adhesive Probability (MAP) Score.
Materials And Methods:
A retrospective analysis was performed on 197 patients who underwent LPN for localized renal tumors between December 2019 and September 2025. Demographic, clinical, radiological, intraoperative, and postoperative variables were collected. Sticky fat was defined intraoperatively. MAP scores were calculated using posterior perinephric fat thickness and fat stranding. Statistical analyses included Mann-Whitney U and Chi-square tests, as well as univariate and multivariate logistic regression (Backward LR method). ROC analysis was used to determine predictive performance.
Results:
The mean age was 61.3 ± 13.1 years, and 63.5% of patients were male. Sticky fat was observed in 41.6% of cases. Male gender (71.3% vs. 52.4%, p = 0.007), older age (62.9 vs. 58 years, p = 0.031), and higher MAP scores (p = 0.005) were significantly associated with sticky fat. Multivariate analysis identified male gender (OR = 1.97; 95% CI: 1.07-3.61; p = 0.029) and MAP score (OR = 1.27; 95% CI: 1.04-1.56; p = 0.021) as independent predictors. Combining MAP score and gender improved predictive accuracy (AUC = 0.645).
Conclusions:
Male gender independently predicts APF, and combining gender with MAP score enhances preoperative assessment and surgical planning.
