减肥手术对肥胖男性性功能障碍的影响。
Impact of Bariatric Surgery on Sexual Dysfunction in Obese Men.
作者信息
Fahmy Ahmed, Abdeldaiem Hussien, Abdelsattar Mohamed, Aboyoussif Tamer, Assem Akram, Zahran Abdelrahman, Elgebaly Omar
机构信息
Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
出版信息
Sex Med. 2021 Apr;9(2):100322. doi: 10.1016/j.esxm.2021.100322. Epub 2021 Feb 13.
INTRODUCTION
Currently bariatric surgery is the most effective treatment for significant and sustained weight loss. Erectile and endothelial dysfunctions may share some metabolic and vascular pathways in common that may be influenced by weight loss.
AIM
The aim of the study was to assess the impact of surgically induced weight loss on the erectile function on obese patients undergoing laparoscopic sleeve gastrectomy (LSG). We also aimed to examine the proposed underlying mechanism associated with improvement in erectile function after weight loss by LSG.
METHODS
Eighty-two consecutive obese men who underwent a LGS were followed up for 12 months. All operations were performed by the same surgeon at a single institution.
MAIN OUTCOME MEASURE
Patients were examined both before and after 12 months of LSG for biochemical tests; total serum cholesterol, triglyceride, C-reactive protein, interleukin-6, and endothelial nitric oxide synthase, and for erectile function tests. International Index of Erectile Function (IIEF) scores were recorded.
RESULTS
Eighty-two men (mean age 39 ± 14.6 years, range 24-62; mean BMI 41.2 ± 4.8 kg/m) completed all preoperative and postoperative questionnaires and biochemical tests. At 12 months, the mean weight loss was 34.8 kg and the mean BMI decrease was 8.6 kg/m. Preoperative and postoperative IIEF scores of the 65 sexually active patients showed significant improvement in erectile function (21.2 ± 5.7 vs 26.5 ± 4.5; P = .02). Seventeen (20.7%) men were not sexually active preoperatively; only 5 became sexually active postoperatively. Men had a significant decrease in serum cholesterol and triglyceride levels. Nitric oxide synthase activity showed a significant increase (P < .02). In addition, our patients showed a statistically significant decrease in interleukin-6 levels and C-reactive protein compared with preoperative period (P < .03 and P < .01, respectively).
CONCLUSION
A significant improvement of erectile function was documented among obese young men undergoing LGS. This improvement was documented both clinically by improvement in IIEF score postoperatively and biochemically. A Fahmy, H Abdeldaiem, M Abdelsattar, et al. Impact of Bariatric Surgery on Sexual Dysfunction in Obese Men. Sex Med 2021;9:100322.
引言
目前，减肥手术是实现显著且持续体重减轻的最有效治疗方法。勃起功能障碍和内皮功能障碍可能共享一些代谢和血管途径，而这些途径可能会受到体重减轻的影响。
目的
本研究的目的是评估手术引起的体重减轻对接受腹腔镜袖状胃切除术（LSG）的肥胖患者勃起功能的影响。我们还旨在研究LSG术后体重减轻后勃起功能改善的潜在机制。
方法
对82例连续接受LGS的肥胖男性进行了12个月的随访。所有手术均由同一机构的同一位外科医生进行。
主要观察指标
在LSG术后12个月前后对患者进行生化检查，包括总血清胆固醇、甘油三酯、C反应蛋白、白细胞介素-6和内皮型一氧化氮合酶，并进行勃起功能测试。记录国际勃起功能指数（IIEF）评分。
结果
82名男性（平均年龄39±14.6岁，范围24 - 62岁；平均BMI 41.2±4.8kg/m²）完成了所有术前和术后问卷及生化检查。12个月时，平均体重减轻34.8kg，平均BMI下降8.6kg/m²。65名性活跃患者术前和术后的IIEF评分显示勃起功能有显著改善（21.2±5.7 vs 26.5±4.5；P = 0.02）。17名（20.7%）男性术前无性生活；术后只有5名恢复了性生活。男性血清胆固醇和甘油三酯水平显著降低。一氧化氮合酶活性显著增加（P < 0.02）。此外，与术前相比，我们的患者白细胞介素-6水平和C反应蛋白水平有统计学显著下降（分别为P < 0.03和P < 0.01）。
结论
在接受LGS的肥胖年轻男性中，勃起功能有显著改善。这种改善在临床上通过术后IIEF评分的提高得以体现，在生化方面也有所体现。A Fahmy、H Abdeldaiem、M Abdelsattar等。减肥手术对肥胖男性性功能障碍的影响。《性医学》2021；9：100322。
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