Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Jinan University Institute of Obesity and Metabolic Disorders, Guangzhou, China.
Front Endocrinol (Lausanne). 2023 Jan 24;13:1036243. doi: 10.3389/fendo.2022.1036243. eCollection 2022.
Bariatric surgeries induce well-documented weight loss and resolve obesity comorbidities. Sexual function is one of the aspects of life quality and may benefit from surgery. Few studies have revealed the impact of bariatric surgeries on sexual function in Chinese men with obesity.
This is a retrospective cohort study of patients undergoing bariatric surgery [laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB)]. Data were collected between September 2017 and February 2022. The International Index of Erectile Function (IIEF) questionnaire was used to evaluate erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. Sex hormones and other blood tests were evaluated before and at least 1 year after the surgery.
Fifty-nine Chinese male patients completed the IIEF questionnaire. The multivariate logistic regression analysis revealed that body mass index (BMI) was the single independent risk factor of the severity of erectile dysfunction (ED). Preoperative testosterone levels had negative correlations with BMI and waist circumference. Thirty-seven patients completed the postoperative questionnaire with a mean follow-up of 23.2 months.
BMI and waist circumference were negatively correlated with testosterone levels. BMI was an independent risk factor for the severity of ED. LSG and LRYGB led to positive and sustained improvement in sexual function of men with obesity. The two procedures had a comparable effect, more subjects being needed. Sex hormone levels also could be reversible. However, more weight loss did not predict a positive change in sexual function. A greater BMI loss might predict a greater increase in testosterone.
减重手术可显著减轻体重并解决肥胖相关并发症。性功能是生活质量的一个方面，可能会从手术中受益。少数研究揭示了减重手术对中国肥胖男性性功能的影响。
这是一项回顾性队列研究，纳入了接受减重手术（腹腔镜袖状胃切除术[LSG]或腹腔镜 Roux-en-Y 胃旁路术[LRYGB]）的患者。数据收集于 2017 年 9 月至 2022 年 2 月。采用国际勃起功能指数（IIEF）问卷评估勃起功能、性交满意度、性高潮功能、性欲和总体满意度。手术前后评估了性激素和其他血液检查。
59 名中国男性患者完成了 IIEF 问卷。多变量逻辑回归分析显示，体重指数（BMI）是勃起功能障碍（ED）严重程度的唯一独立危险因素。术前睾酮水平与 BMI 和腰围呈负相关。37 名患者完成了术后问卷调查，平均随访 23.2 个月。
BMI 和腰围与睾酮水平呈负相关。BMI 是 ED 严重程度的独立危险因素。LSG 和 LRYGB 可使肥胖男性的性功能得到积极和持续的改善。两种手术的效果相当，需要更多的研究对象。性激素水平也可能是可逆的。然而，更多的体重减轻并不能预测性功能的改善。更大的 BMI 减轻可能预示着睾酮水平的更大增加。
