What challenges do obese urologic patients present, and how do you handle them?

I don't tell people they have to lose weight before surgery, other than robotic surgery. Losing weight definitely helps with robotics.

Size doesn't interfere with what I do on reconstructive procedures. Wound healing may have higher complication rates, and the more overweight a person is, the less they move around after an operation, and we definitely like them to move."

Equipment issues can be legitimate concerns; some tables, such as the lithotripsy tables, have weight limits.

There are some procedures that are not life threatening, and we delay treatment as long it's not detrimental to the patient's health and ask them to lose weight."

Timothy Langford, MD
Little Rock, AR

It was challenging treating obese patients; I needed more assistance in the operating room to help retract tissues, but I wouldn't refuse to take care of a patient because he was sick, and a person who is morbidly obese is sick.

If there is an opportunity to delay treatment while a patient is losing weight, that's great.

If a person isn't comfortable treating an obese patient and doesn't have the equipment needed to treat them, they should refer them to somebody else who can do it."

Richard Amelar, MD
Chester, NY

"Where I am limited is in what I can do for them. If an obese patient has a significant panniculus, it's physically impossible to teach them self-catheterization, because their arms just aren't long enough. Doing radiologic studies in my office is also problematic.

If they're really obese and need a surgical procedure, I will flatly decline it and tell them I am not the right person."

David Buntley, MD
Duncan, OK