减肥手术对男性性功能的影响：一项荟萃分析与系统评价
Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review.
作者信息
Xu Jiangnan, Wu Qian, Zhang Yuhui, Pei Changsong
机构信息
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China; Soochow University, Suzhou, China.
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China; Soochow University, Suzhou, China.
出版信息
Sex Med. 2019 Sep;7(3):270-281. doi: 10.1016/j.esxm.2019.06.003. Epub 2019 Jul 10.
INTRODUCTION
Obesity is a worldwide public health issue with serious psychological and social impacts. Erectile dysfunction is also a common clinical condition, and obesity is one of its main risk factors.
OBJECTIVE
The objective of this study was to systematically evaluate the effect of bariatric surgery on male sexual function.
METHODS
A systematical research was carried out in Medline via PubMed, EMBASE, Cochrane Library, and Web of Science up to March 16, 2019, to identify published articles related to bariatric surgery and male sexual function in men. Two reviewers screened literature, extracted data, and assessed the quality of included studies. I index was applied to estimate the heterogeneity. All analyses were done using RevMan5.3 and Stata14.
RESULTS
A total of 12 studies involving 420 participants were included. Analysis showed that bariatric surgery significantly reduced body mass index in morbidly obese patients (mean difference [MD] = -13.73; 95% CI -17.23 to -10.22; P < .00001). From 10 studies that reported the International Index of Erectile Function (IIEF) score, bariatric surgery led to a significant increase in IIEF-total score (MD = 8.2; 95% CI = 5.52-10.88; P < .00001), and erectile function score (MD = 3.76; 95% CI = 2.34-5.19; P < .00001), sexual desire (MD = 0.93; 95% CI = 0.55-1.32; P < .00001), sexual intercourse satisfaction (MD = 1.73; 95% CI = 0.43-3.03; P < .01), and total satisfaction (MD = 1.28; 95% CI = 0.56-2.00; P = .0005) were also significantly improved. However, bariatric surgery did not affect orgasm function (MD = 0.26; 95% CI = -0.15 to 0.68; P = .21). Three studies that reported the IIEF-5 score also showed a significant improvement of erectile function (MD = 5.45; 95% CI = 3.38-7.52; P < .00001).
CONCLUSIONS
Bariatric surgery could improve the erectile function, sexual desire, sexual intercourse satisfaction, and total satisfaction in morbidly obese men. Due to limited data on body mass index and hormone levels, our meta-analysis had some limitations. More clinical studies are needed to further explore the relationship between bariatric surgery and male sexual function. Xu J, Wu Q, Zhang Y, et al. Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review. Sex Med 2019;7:270-281.
引言
肥胖是一个全球性的公共卫生问题，具有严重的心理和社会影响。勃起功能障碍也是一种常见的临床病症，肥胖是其主要危险因素之一。
目的
本研究的目的是系统评价减肥手术对男性性功能的影响。
方法
截至2019年3月16日，通过PubMed、EMBASE、Cochrane图书馆和Web of Science在Medline中进行了系统检索，以识别已发表的与减肥手术和男性性功能相关的文章。两名评审员筛选文献、提取数据并评估纳入研究的质量。应用I指数评估异质性。所有分析均使用RevMan5.3和Stata14完成。
结果
共纳入12项研究，涉及420名参与者。分析表明，减肥手术显著降低了病态肥胖患者的体重指数（平均差值[MD]=-13.73；95%置信区间-17.23至-10.22；P<.00001）。从10项报告国际勃起功能指数（IIEF）评分的研究来看，减肥手术使IIEF总分显著增加（MD=8.2；95%置信区间=5.52-10.88；P<.00001），勃起功能评分（MD=3.76；95%置信区间=2.34-5.19；P<.00001）、性欲（MD=0.93；95%置信区间=0.55-1.32；P<.00001）、性交满意度（MD=1.73；95%置信区间=0.43-3.03；P<.01）和总体满意度（MD=1.28；95%置信区间=0.56-2.00；P=.0005）也得到显著改善。然而，减肥手术对性高潮功能没有影响（MD=0.26；95%置信区间=-0.15至0.68；P=.21）。三项报告IIEF-5评分的研究也显示勃起功能有显著改善（MD=5.45；95%置信区间=3.38-7.52；P<.00001）。
结论
减肥手术可以改善病态肥胖男性的勃起功能、性欲、性交满意度和总体满意度。由于关于体重指数和激素水平的数据有限，我们的荟萃分析存在一些局限性。需要更多的临床研究来进一步探讨减肥手术与男性性功能之间的关系。徐J、吴Q、张Y等。减肥手术对男性性功能的影响：一项荟萃分析和系统评价。性医学2019；7：270-281。
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