Radical perineal prostatectomy in obese patients

Objectives. To evaluate the efficacy of radical perineal prostatectomy in obese patients. No study has ever been published providing evidence of success of any type of prostatectomy specifically in patients with significant truncal obesity. Methods. A retrospective review of 103 patients who underwent radical perineal prostatectomy between 1996 and 2002 was performed. Obesity is defined as having a body mass index greater than 30 kg/m². Seven obese patients were found. The operative time, blood loss, hospital length of stay, perioperative complications, urinary continence, and quality of specimen were assessed. Results. The mean age was 61 years (range 56 to 67). The body mass index ranged between 30.21 and 47.9 (average 39.27). The average operative time and blood loss was 142 minutes and 542 mL, respectively. No complications occurred and no blood transfusions were needed perioperatively. Two specimens had a positive surgical margin. Six (85.7%) of the 7 patients went home on postoperative day 2; the remaining patient left on day 3. The 1-year continence rate was 66%. Conclusions. Radical perineal prostatectomy remains an excellent option for obese patients. It remains to be seen if this is the case with radical retropubic prostatectomy.