{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T09:43:59Z","timestamp":1776678239175,"version":"3.51.2"},"reference-count":21,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Obesity has been associated with the development and severity of benign prostatic hyperplasia (BPH), yet its influence on outcomes following definitive surgical management, like holmium laser enucleation of the prostate (HoLEP), remains unclear. Furthermore, gradation of body mass index (BMI) severity has yet to discern personalized outcome stratification. We evaluated BMI\u2019s influence on perioperative, immediate, short-term follow-up, and patient-reported outcomes for HoLEP patients. Methods: We performed a retrospective review of a prospectively maintained database of patients undergoing HoLEP for BPH at a single institution between January 2021 and August 2025. Outcomes included operative characteristics, post-operative complications, and validated symptom score changes. Analyses treated BMI as both a continuous and categorical variable. Multivariable linear and logistic regression models adjusted for common colinear confounders. Results: Among 1445 patients, BMI was not associated with most immediate, three-month, or patient-reported outcomes. Surgical complications were low across all BMI categories, and post-operative reported outcomes indicating high success rate for HoLEP. Higher BMI correlated with a modest increase in enucleation time (\u03b2 = 0.197; p = 0.0132), increased odds of dysuria (OR = 1.084; p &lt; 0.001), and change in American Urological Association Symptom Score (\u03b2 = 0.211; p = 0.0334). All other operative metrics, complication rates, continence outcomes, and symptom scores (17 other total) were independent of BMI. Conclusions: After adjustment for relevant confounders, BMI does not meaningfully predict surgical safety, functional recovery, or patient-reported benefit following HoLEP. BMI alone should not influence candidacy or risk stratification for HoLEP in patients with BPH, instead favoring personalized, risk-stratified approaches.<\/jats:p>","DOI":"10.3390\/jpm16040225","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:24:23Z","timestamp":1776673463000},"page":"225","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Mass Index Lacks Predictive Influence on Perioperative, Short-Term Follow-Up, and Patient-Reported Outcomes from Holmium Laser Enucleation of the Prostate"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6756-2800","authenticated-orcid":false,"given":"Jack T.","family":"Peterson","sequence":"first","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny N.","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Urology, Oregon Health and Science University, Portland, OR 97239, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabila","family":"Khondakar","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perry","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy E.","family":"Krambeck","sequence":"additional","affiliation":[{"name":"Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S102","DOI":"10.1016\/j.juro.2012.11.029","article-title":"Obesity and Benign Prostatic Hyperplasia: Clinical Connections, Emerging Etiological Paradigms and Future Directions","volume":"189","author":"Parsons","year":"2013","journal-title":"J. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1097\/01.ju.0000155709.37840.fe","article-title":"Urologic Diseases in America Project: Benign Prostatic Hyperplasia","volume":"173","author":"Wei","year":"2005","journal-title":"J. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.prnil.2015.08.001","article-title":"The Impact of Obesity towards Prostate Diseases","volume":"4","author":"Parikesit","year":"2016","journal-title":"Prostate Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/j.eururo.2013.02.038","article-title":"Obesity Is Associated with Increased Prostate Growth and Attenuated Prostate Volume Reduction by Dutasteride","volume":"63","author":"Muller","year":"2013","journal-title":"Eur. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.2147\/CIA.S472579","article-title":"Impact of Obesity on Clinical Presentation and Surgical Outcomes in Patients with Benign Prostate Hyperplasia Receiving Greenlight Laser Prostatectomy","volume":"19","author":"Chen","year":"2024","journal-title":"Clin. Interv. Aging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1186\/2193-1801-2-537","article-title":"Influence of Body Mass Index on Benign Prostatic Hyperplasia-Related Complications in Patients Undergoing Prostatectomy","volume":"2","author":"Mosli","year":"2013","journal-title":"SpringerPlus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.ajur.2018.05.004","article-title":"Safety and Feasibility of Thullium Laser Transurethral Resection of Prostate for the Treatment of Benign Prostatic Enlargement in Overweight Patients","volume":"6","author":"Carmignani","year":"2019","journal-title":"Asian J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/JU.0000000000003698","article-title":"Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia (BPH): AUA Guideline Amendment 2023","volume":"211","author":"Sandhu","year":"2024","journal-title":"J. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Batai, K., Phung, M., Bell, R., Lwin, A., Hynes, K.A., Price, E., Meiklejohn, K.M., Bracamonte, E.R., and Funk, J.T. (2021). Correlation between Body Mass Index and Prostate Volume in Benign Prostatic Hyperplasia Patients Undergoing Holmium Enucleation of the Prostate Surgery. BMC Urol., 21.","DOI":"10.1186\/s12894-020-00753-9"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1177\/20514158211043007","article-title":"How Obesity Affects the Benefits of Holmium Laser Enucleation of the Prostate for the Treatment of Male Lower Urinary Tract Symptoms","volume":"16","author":"Tamalunas","year":"2023","journal-title":"J. Clin. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.urology.2020.08.017","article-title":"Morphologic Factors Associated with Open Conversion During Holmium Laser Enucleation of the Prostate","volume":"145","author":"Juvet","year":"2020","journal-title":"Urology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"255","DOI":"10.5489\/cuaj.8683","article-title":"Comparison of Outcomes in Patients with and without Neurologic Diseases Undergoing Holmium Laser Enucleation of the Prostate","volume":"18","author":"Guo","year":"2024","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1089\/end.2020.0077","article-title":"Impact of Body Mass Index on Outcomes Following Anatomic GreenLight Laser Photoselective Vaporization of the Prostate","volume":"35","author":"Pierce","year":"2021","journal-title":"J. Endourol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/bju.13038","article-title":"Central Obesity Is Predictive of Persistent Storage Lower Urinary Tract Symptoms (LUTS) after Surgery for Benign Prostatic Enlargement: Results of a Multicentre Prospective Study","volume":"116","author":"Gacci","year":"2015","journal-title":"BJU Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"F887","DOI":"10.1152\/ajprenal.00489.2016","article-title":"Path of Translational Discovery of Urological Complications of Obesity and Diabetes","volume":"312","author":"Daneshgari","year":"2017","journal-title":"Am. J. Physiol. Renal Physiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.53350\/pjmhs211561888","article-title":"The Association between Obesity and Prostate Volume in Patients with Benign Prostatic Hyperplasia","volume":"15","author":"Rehman","year":"2021","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2026). Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes\u20142026. Diabetes Care, 49, S261\u2013S276.","DOI":"10.2337\/dc26-S012"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.urology.2017.03.040","article-title":"The Relationship Between Diabetes, Diabetes Severity, Diabetes Biomarkers, and the Presence of Lower Urinary Tract Symptoms: Findings from the National Health and Nutrition Examination Survey","volume":"105","author":"Tam","year":"2017","journal-title":"Urology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.urology.2021.12.010","article-title":"Conversion of Holmium Laser Enucleation of Prostate to Open Prostatectomy","volume":"161","author":"Shvero","year":"2022","journal-title":"Urology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/luts.12404","article-title":"Holmium Laser Enucleation of the Prostate: A Truly Size-Independent Method?","volume":"14","author":"Tamalunas","year":"2022","journal-title":"Low. Urin. Tract Symptoms"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s00345-024-05130-x","article-title":"Optimizing Hemostasis in HoLEP Surgery: Retrospective Review of Selective Bipolar Plasmakinetic Technology Guided by Bladder Irrigation Fluid Color","volume":"42","author":"Hu","year":"2024","journal-title":"World J. Urol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/4\/225\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T08:47:18Z","timestamp":1776674838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/4\/225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,18]]},"references-count":21,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["jpm16040225"],"URL":"https:\/\/doi.org\/10.3390\/jpm16040225","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,18]]}}}