In this study, we found that the primary biopsy GS and secondary biopsy GS values were significant predictors of GSU in all patients undergoing RP, while the PSA, PSAD, number of positive biopsy cores, percentage of positive cores, and obesity were predictors of GSU in patients with GS=6. Here, KLK3 is linked to obesity due to melanocortin 4 receptor deficiency.