INCREASED BODY MASS INDEX AS A PREDICTOR OF COMPLICATIONS AFTER ROBOT-ASSISTED PROSTATECTOMY

Background. Increased body mass index (BMI) is one of the main factors affecting the restoration of urine retention and erectile function after a robot-assisted prostatectomy (RARP). Purpose. To determine the extent to which increased BMI affects functional results after robot-assisted prostatectomy. Materials and Methods. From 2017 to 2023, a prospective study was conducted at the National Medical and Surgical Center named after N.I. Pirogov to determine the effect of increased BMI on the restoration of functional outcomes after a robot-assisted prostatectomy. The number of the patients included in the study was 100 people, divided into 2 groups equally. Group 1 had patients with increased BMI (≥30). Group 2 included patients with normal BMI. The quality of life of patients in both groups was determined using the IPSS (International Prostate Symptom Score) and IIEF-5 (International Index of Erectile Function) questionnaires. For the reliability of the study, all patients underwent RARP performed by one surgeon using the same technique with bilateral preservation of the neurovascular bundles of the pancreas. Results. In order to determine the presence and severity of erectile dysfunction during the pre-treatment examination before the RARP, the IIEF-5 questionnaire was used. The final result in patients of group 1 averaged 17±3 points [14; 20], and in group 2 the same index was 22±2 points [20; 24]. After the expiration of the dynamic follow-up period, all patients re-completed the IIEF-5 questionnaire. Also during the study, the International Conference on Incontinence Questionnaire — Short Form (ICIQ — SF) was used to determine the patients’ quality of life dependent on “urination disorder”. In the postoperative period, the patients in group 1 had the final score of 10±3 [7; 13] points, and in group 2, the same indicator was 4±1 [3; 5] points. Conclusion. Increased BMI is a predisposing factor for urinary incontinence and erectile dysfunction (ED) in the postoperative period after RARP.