Bariatric surgery leads to long term lower urinary tract symptoms (LUTS) improvement in male patients with severe obesity: 5-year results from a prospective within-subject cohort study.

Abstract

Background: Obesity is a known risk factor for lower urinary tract symptoms (LUTS). Current literature has not described the long-term effect of bariatric surgery on male LUTS.

Objectives: To investigate the 5-year long-term follow-up data on the effect of bariatric surgery on LUTS improvement in male patients with severe obesity.

Setting: University Hospital, Hong Kong.

Methods: This is a prospective cohort study. All consecutive male patients from 2010-2020 undergoing bariatric surgery were recruited, with prospective collection of preoperative and postoperative International Prostate Symptom Score (IPSS), anthropometric measurements, metabolic syndrome parameters, and blood parameters. Within-subject analysis was performed to compare the changes in IPSS over time.

Results: One hundred seventy-three male patients were included. There was statistically significant IPSS total symptom score improvement up to 4 years after bariatric surgery in all patients (6.87 versus 5.63, P = .037) and up to 5 years in patients with moderate-to-severe baseline LUTS (13.53 versus 10.03, P = .001). The quality-of-life score was statistically significantly improved up to 5 years. Both voiding and storage symptom showed statistically significant improvement. Univariate and multivariable logistic regression showed percentage change in waist circumference to be a significant predictor of a clinically significant IPSS improvement of 3 or more.

Conclusions: This is the largest cohort with the longest follow-up duration demonstrating the lasting effect of bariatric surgery on the improvement of male LUTS in male patients with severe obesity. Statistically and clinically significant improvement in IPSS symptoms, both voiding and storage, were observed, especially in patients with baseline moderate-to-severe LUTS.