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Cited by 37Sexual function and dysfunction studiesBariatric Surgery and OutcomesBody Contouring and Surgery

Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review

Open access
Xu, Jiangnan, Wu, Qian, Zhang, Yuhui, Pei, Changsong·2019·Sexual Medicine
DOI 10.1016/j.esxm.2019.06.003PMC PMC6728768
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Abstract

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. I2 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.

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  • A meta-analysis of 12 studies in 420 patients reported that weight loss after bariatric surgery significantly improved erectile function, sexual desire and sexual intercourse satisfaction.

    “A meta-analysis of 12 studies in 420 patients reported that weight loss after bariatric surgery significantly improved erectile function, sexual desire and sexual intercourse satisfaction [26].”

    From Treatment of Men with Central Hypogonadism: Alternatives for Testosterone Replacement Therapy (2020) · cites this paper as [26]

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  1. [1]Ng M. Fleming T. Robinson M. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013 Lancet 384 2014 766 781 24880830 PMC4624264
  2. [2]NCD Risk Factor Collaboration (NCD-RisC) Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults Lancet 390 2017 2627 2642 29029897 PMC5735219
  3. [3]Adams K.F. Schatzkin A. Harris T.B. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old N Engl J Med 355 2006 763 778 16926275
  4. [4]LeBlanc E.S. Patnode C.D. Webber E.M. Behavioral and pharmacotherapy weight loss interventions to prevent obesity-related morbidity and mortality in adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force JAMA 320 2018 1172 1191 30326501 PMC13151892
  5. [5]Pastuszak A.W. Badhiwala N. Lipshultz L.I. Depression is correlated with the psychological and physical aspects of sexual dysfunction in men Int J Impot Res 25 2013 194 199 23466661
  6. [7]Hadi H.A. Carr C.S. Al Suwaidi J. Endothelial dysfunction: Cardiovascular risk factors, therapy, and outcome Vasc Health Risk Manag 1 2005 183 198 17319104 PMC1993955
  7. [8]Skrypnik D. Bogdanski P. Musialik K. [Obesity--significant risk factor for erectile dysfunction in men] Pol Merkur Lekarski 36 2014 137 141 [in Polish] 24720114
  8. [9]Knoblovits P. Costanzo P.R. Valzacchi G.J. Erectile dysfunction, obesity, insulin resistance, and their relationship with testosterone levels in eugonadal patients in an andrology clinic setting J Androl 31 2010 263 270 19834133
  9. [10]Silva F.H. Alexandre E.C. Calmasini F.B. Treatment with metformin improves erectile dysfunction in a murine model of obesity associated with insulin resistance Urology 86 2015 423.e1 423.e6 26199165
  10. [11]Fernández-Sánchez A. Madrigal-Santillán E. Bautista M. Inflammation, oxidative stress, and obesity Int J Mol Sci 12 2011 3117 3132 21686173 PMC3116179
  11. [12]Aguiar I.C. Freitas W.R. Jr. Santos I.R. Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: A randomized clinical trial Multidiscip Respir Med 9 2014 43 25136444 PMC4135715
  12. [14]Boido A. Ceriani V. Cetta F. Bariatric surgery and prevention of cardiovascular events and mortality in morbid obesity: Mechanisms of action and choice of surgery Nutr Metab Cardiovasc Dis 25 2015 437 443 25770762
  13. [15]Brethauer S.A. Aminian A. Romero-Talamás H. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus Ann Surg 258 2013 628 636 [discussion: 636-637] 24018646 PMC4110959
  14. [16]Sarwer D.B. Spitzer J.C. Wadden T.A. Sexual functioning and sex hormones in men who underwent bariatric surgery Surg Obes Relat Dis 11 2015 643 651 25868832 PMC8424430
  15. [17]Janik M.R. Bielecka I. Podgórska L. Bujok J. Paśnik K. Male sexual function before and after bariatric surgery: A cross-sectional study Obes Surg 25 2015 S220 PMC4498227 25990378
  16. [18]Groutz A. Gordon D. Schachter P. Effects of bariatric surgery on male lower urinary tract symptoms and sexual function Neurourol Urodyn 36 2017 636 639 26879634
  17. [19]Aleid M. Muneer A. Renshaw S. Early effect of bariatric surgery on urogenital function in morbidly obese men J Sex Med 14 2017 205 214 28087357
  18. [20]Moher D. Liberati A. Tetzlaff J. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement Int J Surg 8 2010 336 341 20171303
  19. [21]Rosen R.C. Riley A. Wagner G. The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction Urology 49 1997 822 830 9187685
  20. [22]Rosen R.C. Cappelleri J.C. Smith M.D. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction Int J Impot Res 11 1999 319 326 10637462
  21. [23]Slim K. Nini E. Forestier D. Methodological index for non-randomized studies (minors): Development and validation of a new instrument ANZ J Surg 73 2003 712 716 12956787
  22. [24]Berger V.W. Is the Jadad score the proper evaluation of trials? J Rheumatol 33 2006 1710 1711 16881132
  23. [25]Fu R, Holmer HK. Change score or followup score? An empirical evaluation of the impact of choice of mean difference estimates [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015 Apr. Report No.: 15-EHCV016-EF. 25927135
  24. [26]Wan X. Wang W. Liu J. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range BMC Med Res Methodol 14 2014 135 25524443 PMC4383202
  25. [27]Araújo A.A. Brito A.M. Ferreira Mde N. Petribú K. [Changes the sexual quality of life of the obeses submitted Fobi-Capella gastroplasty surgery] Rev Col Bras Cir 36 2009 42 48 [in Portuguese] 20076867
  26. [28]Reis L.O. Favaro W.J. Barreiro G.C. Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: A prospective randomized controlled trial Int J Androl 33 2010 736 744 20039972
  27. [29]Ranasinghe W.K. Wright T. Attia J. Effects of bariatric surgery on urinary and sexual function BJU Int 107 2011 88 94 20707800
  28. [30]Mora M. Aranda G.B. de Hollanda A. Weight loss is a major contributor to improved sexual function after bariatric surgery Surg Endosc 27 2013 3197 3204 23612762
  29. [31]Sarwer D.B. Spitzer J.C. Wadden T.A. Sexual functioning and sex hormones in persons with extreme obesity and seeking surgical and nonsurgical weight loss Surg Obes Relat Dis 9 2013 997 1007 24120985 PMC3864660
  30. [32]Kun L. Pin Z. Jianzhong D. Significant improvement of erectile function after Roux-en-Y gastric bypass surgery in obese Chinese men with erectile dysfunction Obes Surg 25 2014 838 844 25361762
  31. [34]Efthymiou V. Hyphantis T. Karaivazoglou K. The effect of bariatric surgery on patient HRQOL and sexual health during a 1-year postoperative period Obes Surg 25 2015 310 318 25085222
  32. [35]Dallal R.M. Chernoff A. O'Leary M.P. Sexual dysfunction is common in the morbidly obese male and improves after gastric bypass surgery J Am Coll Surg 207 2008 859 864 19183532
  33. [36]Lee Y. Dang J.T. Switzer N. Impact of bariatric surgery on male sex hormones and sperm quality: A systematic review and meta-analysis Obes Surg 29 2019 334 346 30382463
  34. [38]Botella-Carretero J.I. Balsa J.A. Gómez-Martin J.M. Circulating free testosterone in obese men after bariatric surgery increases in parallel with insulin sensitivity J Endocrinol Invest 36 2013 227 232 22732238
  35. [39]Csipo T. Fulop G.A. Lipecz A. Short-term weight loss reverses obesity-induced microvascular endothelial dysfunction Geroscience 2018 [Epub ahead of print] PMC6060194 29916025
  36. [40]Bondia-Pons I. Ryan L. Martinez J.A. Oxidative stress and inflammation interactions in human obesity J Physiol Biochem 68 2012 701 711 22351038
  37. [43]Pontiroli A.E. Pizzocri P. Paroni R. Sympathetic overactivity, endothelial dysfunction, inflammation, and metabolic abnormalities cluster in grade III (World Health Organization) obesity: Reversal through sustained weight loss obtained with laparoscopic adjustable gastric banding Diabetes Care 29 2006 2735 2738 17130217
  38. [44]Aversa A. Isidori A.M. De Martino M.U. Androgens and penile erection: Evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction Clin Endocrinol (Oxf) 53 2000 517 522 11012578
  39. [45]Traish A.M. Park K. Dhir V. Effects of castration and androgen replacement on erectile function in a rabbit model Endocrinology 140 1999 1861 1868 10098525
  40. [46]Salminen P. Helmiö M. Ovaska J. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: The SLEEVEPASS Randomized Clinical Trial JAMA 319 2018 241 254 29340676 PMC5833550
  41. [47]Avenell A. Robertson C. Skea Z. Bariatric surgery, lifestyle interventions and orlistat for severe obesity: The REBALANCE mixed-methods systematic review and economic evaluation Health Technol Assess 22 2018 1 246 PMC6296173 30511918
  42. [48]Azagury D. Mokhtari T.E. Garcia L. Heterogeneity of weight loss after gastric bypass, sleeve gastrectomy, and adjustable gastric banding Surgery 165 2019 565 570 30316577
  43. [49]Ahmed B. King W.C. Gourash W. Long-term weight change and health outcomes for sleeve gastrectomy (SG) and matched Roux-en-Y gastric bypass (RYGB) participants in the Longitudinal Assessment of Bariatric Surgery (LABS) study Surgery 164 2018 774 783 30139560 PMC6594190

Cited by

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Authors
Xu, J., Wu, Q., Zhang, Y., & Pei, C.
Affiliations
  • Soochow University (CN)
  • Department of Urology , Suzhou , China
ORCID
Venue
Sexual Medicine
Publisher
Oxford University Press (OUP)
Published
2019-07-10
Volume
7
Issue
3
Pages
270-281
ISSN
2050-1161 (ISSN-L)
DOI
10.1016/j.esxm.2019.06.003
PMC
PMC6728768
OpenAlex
W2956545872
Cited by
37
References
2
Citations by year
2026: 5 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 1
FWCI
0.71
Type
journal article
Language
en
Open access
Licence
Locations
  • Sexual Medicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords
bariatric surgery, male sexual function, erectile dysfunction, obesity, morbid obesity, sexual desire, International Index of Erectile Function, body mass index reduction, male sexual health, obesity treatment outcomes

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