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The prevalence of obesity has risen dramatically worldwide. Beyond its metabolic implications, obesity profoundly impacts sexual health, particularly in males, with erectile dysfunction emerging as a prevalent and distressing comorbidity. Studies show that bariatric surgery alleviates erectile dysfunction. Patients suffering from obesity have lower testosterone levels, which increase after weight-loss surgery. This study aims to investigate the relationship between erectile dysfunction improvement, weight loss and hormonal changes after surgery.
In recent decades, the prevalence of obesity has risen dramatically worldwide, presenting significant public health concerns. Beyond its metabolic implications, obesity profoundly impacts sexual health, particularly in males, with erectile dysfunction (ED) emerging as a prevalent and distressing comorbidity. Obesity exacerbates the risk of ED through complex interplays of physiological and psychological mechanisms. Physiologically, excess adiposity leads to chronic inflammation, endothelial dysfunction, and hormonal imbalances, all of which contribute to impaired vascular health and reduced testosterone levels, key factors in erectile function. Psychologically, body image dissatisfaction and decreased self-esteem associated with obesity can exacerbate sexual performance anxiety and further contribute to ED. Bariatric surgery is an established treatment method for long-term weight loss which also alleviates symptoms of diabetes, hypertension, and other weight-related comorbidities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Male patients | Male patients undergoing bariatric surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sleeve gastrectomy | Procedure | Each patient undergoes bariatric surgery. Each patient is diagnosed before surgery for erectile dysfunction. Similar tests are done 1 year after |
|
| Measure | Description | Time Frame |
|---|---|---|
| The International Index of Erectile Function score | 6 questions from IIEF official questionnare. Each question is score 1-5. Erectile dysfunction (ED) assessed using a validated tool Patient who scored <25 points were considered for further analysis. Each patient was categorized into severity: 25-30 no ED, 19-24 mild ED, 13-18 mild to moderate ED, 7-12 moderate ED, 0-6 severe ED. After follow-up, patients with prior ED (<25 IIEF) were assigned to three groups: 1 - no improvement, 2 - symptom alleviation (change in severity category), 3 - ED remission | immediately before surgery and one year after |
| Measure | Description | Time Frame |
|---|---|---|
| Weight loss results | weight loss (WL) in kg | one year after surgery |
| percentage of excess weight loss (%EWL) | Weight loss results | one year after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Male patients undergoing weight loss surgery at high volume bariatric centre. Male patiens who are sexually active
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| Name | Affiliation | Role |
|---|---|---|
| Michał Pędziwiatr, Prof. | Jagiellonian University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 2nd Department of General Surgery, Jagiellonian University Medical College | Krakow | Małopolska | 30-688 | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37086370 | Background | Malczak P, Wysocki M, Pisarska-Adamczyk M, Strojek J, Rodak H, Lastovetskyi I, Pedziwiatr M, Major P. Influence of Bariatric Surgery on Erectile Dysfunction-a Systematic Review and Meta-Analysis. Obes Surg. 2023 Jun;33(6):1652-1658. doi: 10.1007/s11695-023-06572-9. Epub 2023 Apr 22. | |
| 31938930 | Background | Arolfo S, Scozzari G, Di Benedetto G, Vergine V, Morino M. Surgically induced weight loss effects on sexual quality of life of obese men: a prospective evaluation. Surg Endosc. 2020 Dec;34(12):5558-5565. doi: 10.1007/s00464-019-07356-y. Epub 2020 Jan 14. |
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| ID | Term |
|---|---|
| D007172 | Erectile Dysfunction |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D012735 | Sexual Dysfunction, Physiological |
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| percentage of total weight loss (%TWL) | Weight loss results | one year after surgery |
| Testoreone (nmol/l) | Laboratory test using blood samples | immediately before surgery and one year after |
| Sex hormone binding (nmol/l) | Laboratory test using blood samples | immediately before surgery and one year after |
| Estradiol (pmol/l) | Laboratory test using blood samples | immediately before surgery and one year after |
| luteinizing hormone (mIU/ml) | Laboratory test using blood samples | immediately before surgery and one year after |
| 17452989 | Result | Cheng JY, Ng EM. Body mass index, physical activity and erectile dysfunction: an U-shaped relationship from population-based study. Int J Obes (Lond). 2007 Oct;31(10):1571-8. doi: 10.1038/sj.ijo.0803639. Epub 2007 Apr 24. |
| D052801 | Male Urogenital Diseases |
| D020018 | Sexual Dysfunctions, Psychological |
| D001523 | Mental Disorders |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |