Abstract
The authors report a retrospective review of the association between body mass index (BMI) and efficacy and safety after 180W GreenLight photoselective vaporization of the prostate (PVP). 1 They found that BMI groups did not differ with respect to operative or lasing time after matching for prostate volume. Higher mean energy was required for the highest BMI group. They concluded that PVP is safe and effective for overweight and obese men. There have been a cadre of studies examining the short- and long-term efficacy and safety of 180W PVP. In addition, the impact of baseline prostate volumes on efficacy and safety has been well described. The authors divide their patients into three groups based on BMI: normal, overweight, and obese. After “propensity score matching” to idealize matched triplets, only lasing energy was higher for the obesity group. The challenge in attempting to analyze numerically disparate groups is the challenge of fitting data into statistical models. Did a clinically meaningful phenomena occur or were the results driven by multiple iterations of statistical analyses? There were much fewer obese than corresponding cohorts, so there is a lingering sense of minimal clinical relevance or impact. Nevertheless, better studies on the role of obesity and metabolic dysfunction on both diagnosis and therapeutics are worthwhile avenues to explore.