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Improved Erectile Function After Bariatric Surgery: Role of Testosterone and Other Factors

Completed
Conditions
Bariatric Surgery
Erectile Dysfunction
Interventions
Procedure: Sleeve gastrectomy
Registration Number
NCT06527170
Lead Sponsor
Jagiellonian University
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
135
Inclusion Criteria
  • patients undergoing laparoscopic sleeve gastrectomy who were qualified according to Guidelines of the International Federation for the Surgery of Obesity and Metabolic Disorders
Exclusion Criteria
  • lack of data during follow-up visit (at 1-year).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Male patientsSleeve gastrectomyMale patients undergoing bariatric surgery
Primary Outcome Measures
NameTimeMethod
The International Index of Erectile Function scoreimmediately before surgery and one year after

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

Secondary Outcome Measures
NameTimeMethod
percentage of total weight loss (%TWL)one year after surgery

Weight loss results

Sex hormone binding (nmol/l)immediately before surgery and one year after

Laboratory test using blood samples

percentage of excess weight loss (%EWL)one year after surgery

Weight loss results

luteinizing hormone (mIU/ml)immediately before surgery and one year after

Laboratory test using blood samples

Testoreone (nmol/l)immediately before surgery and one year after

Laboratory test using blood samples

Estradiol (pmol/l)immediately before surgery and one year after

Laboratory test using blood samples

Weight loss resultsone year after surgery

weight loss (WL) in kg

Trial Locations

Locations (1)

2nd Department of General Surgery, Jagiellonian University Medical College

🇵🇱

Kraków, Małopolska, Poland

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