Groutz Asnat, Gordon David, Schachter Pinhas, Amir Hadar, Shimonov Mordechai
Sackler Faculty of Medicine, Urogynecology and Pelvic Floor Unit, Tel Aviv Sourasky Medical Center, Lis Maternity Hospital, Tel Aviv University, Tel Aviv, Israel.
Sackler Faculty of Medicine, Department of Surgery, E. Wolfson Medical Center, Tel Aviv University, Tel Aviv, Israel.
Neurourol Urodyn. 2017 Mar;36(3):636-639. doi: 10.1002/nau.22980. Epub 2016 Feb 16.
To investigate the effect of bariatric surgery on male lower urinary tract symptoms (LUTS) and sexual function.
Fifty-five consecutive obese men who underwent a laparoscopic sleeve gastrectomy were prospectively enrolled. Two validated questionnaires, the International Prostate Symptoms Score (IPSS) and the International Index of Erectile Function (IIEF) were used to assess LUTS and sexual function, before and 3 months after surgery. Fifty-three men (mean age 39 ± 12.5 years) completed all pre and postoperative questionnaires. Mean body mass index (BMI) before and 3 months after surgery was 42.8 ± 5.3 and 31.3 ± 5.4 kg/m ; respectively.
Preoperatively, 41 (77%) men (mean age 40 ± 12.9, mean BMI 42.2 ± 5 kg/m ) had some degree of LUTS and 39 (74%) men (mean age 40.7 ± 12.4, mean BMI 42.8 ± 5.6 kg/m ) were sexually active. Postoperatively, the total IPSS score decreased significantly (5.5 ± 4.4 vs. 2.7 ± 2.6; P < 0.001), however this change was due to improvement in storage phase LUTS, measured by questions 2, 4, and 7 of the IPSS questionnaire. No statistically significant changes of voiding phase LUTS, measured by questions 1, 3, 5, 6 of the IPSS, were observed. Of the various aspects of sexual dysfunction, only erectile function, measured by questions 1-5 and 15 of the IIEF questionnaire was significantly improved (22.7 ± 7.2 vs. 26.1 ± 6.5, P = 0.02). Postoperative overall intercourse satisfaction (9.5 ± 4.2 vs. 11.5 ± 3, P = 0.01) and overall satisfaction (7.9 ± 2.5 vs. 8.9 ± 1.3, P = 0.02) were significantly improved as well.
Male storage phase LUTS and erectile function were significantly and rapidly improved following bariatric surgery. Larger and long-term studies are required to investigate these apparently beneficial effects. Neurourol. Urodynam. 36:636-639, 2017. © 2016 Wiley Periodicals, Inc.
探讨减肥手术对男性下尿路症状（LUTS）及性功能的影响。
前瞻性纳入55例连续接受腹腔镜袖状胃切除术的肥胖男性。采用两份经过验证的问卷，即国际前列腺症状评分（IPSS）和国际勃起功能指数（IIEF），在手术前及术后3个月评估LUTS和性功能。53例男性（平均年龄39±12.5岁）完成了所有术前和术后问卷。手术前及术后3个月的平均体重指数（BMI）分别为42.8±5.3和31.3±5.4kg/m²。
术前，41例（77%）男性（平均年龄40±12.9岁，平均BMI 42.2±5kg/m²）有一定程度的LUTS，39例（74%）男性（平均年龄40.7±12.4岁，平均BMI 42.8±5.6kg/m²）有性功能。术后，IPSS总分显著下降（5.5±4.4对2.7±2.6；P<0.001），然而这种变化是由于IPSS问卷中问题2、4和7所测量的储尿期LUTS改善。未观察到IPSS中问题1、3、5、6所测量的排尿期LUTS有统计学显著变化。在性功能障碍的各个方面，只有IIEF问卷中问题1-5和15所测量的勃起功能有显著改善（22.7±7.2对26.1±6.5，P=0.02）。术后总体性交满意度（9.5±4.2对11.5±3，P=0.01）和总体满意度（7.9±2.5对8.9±1.3，P=0.02）也显著提高。
减肥手术后男性储尿期LUTS和勃起功能显著且迅速改善。需要更大规模和长期的研究来调查这些明显有益的影响。《神经泌尿学与尿动力学》36:636 - 639，2017。©2016威利期刊公司。
