Effect of Obesity on Urethroplasty Outcome

Objectives: To determine whether obesity increases the risk of urethroplasty failure. Methods: A total of 381 patients underwent urethroplasty and had complete body mass index (BMI) data. Stricture recurrence-free survival was defined as subjective and objective improvement in urinary flow, an absence of radiographic evidence of stricture, and no further need for urethral instrumentation. Cox proportional hazards regression analysis was used to identify both univariate and multivariate predictors of urethroplasty outcome. Results: The median patient age was 40 years (range 18-90). The median follow-up was 5.9 years (range 1 month to 10 years). Of the 381 patients, 60 developed recurrent stricture (15.7%). Overweight (BMI 25-30 kg/m²) and obese (BMI 30-35 kg/m²) patients were more likely to have urethroplasty failure, reaching significance and near significance on univariate and multivariate analysis, respectively (P = .03 and P = .07, respectively). Patients who were severely (BMI 35-40 kg/m²) or morbidly obese (BMI >40 kg/m²) did not have an increased risk of urethroplasty failure. Conclusions: Although obesity's relationship with urethroplasty failure is not linear, it does appear to affect outcomes after urethroplasty.