MP52-03 BARIATRIC SURGERY IMPACT ON ERECTILE FUNCTION, SEMEN PARAMETERS AND SEXUAL HORMONES IN OBESE MEN

The Journal of Urology(2019)

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You have accessJournal of UrologyInfertility: Therapy II (MP52)1 Apr 2019MP52-03 BARIATRIC SURGERY IMPACT ON ERECTILE FUNCTION, SEMEN PARAMETERS AND SEXUAL HORMONES IN OBESE MEN Guilherme Wood*, Bruno Tiseo, Joao Paulo Cardoso, Hamilton de Martin, Marco Aurelio Santo, Miguel Srougi, and Marcello Antonio Cocuzza Guilherme Wood*Guilherme Wood* More articles by this author , Bruno TiseoBruno Tiseo More articles by this author , Joao Paulo CardosoJoao Paulo Cardoso More articles by this author , Hamilton de MartinHamilton de Martin More articles by this author , Marco Aurelio SantoMarco Aurelio Santo More articles by this author , Miguel SrougiMiguel Srougi More articles by this author , and Marcello Antonio CocuzzaMarcello Antonio Cocuzza More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556495.40363.8aAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Despite the major importance of obesity as a global healthy issue, there is a paucity of data regarding its influence on male fertility. Bariatric surgery has become an important treatment option, but little is known of its impact on testicular and sexual function. This study aimed to evaluate the impact of obesity on erectile function, semen analysis (SA) and testicular function, and the influence of bariatric surgery in these parameters. METHODS: The study was performed on 2 phases. On the first phase 32 healthy fertile controls and 42 obese patients were submitted to complete urological evaluation, IEEF-5 score, SA and dosing of sexual hormones. On phase 2, 22 obese patients (Group A1) were submitted to bariatric surgery and 20 remained on conservative treatment (Group A2). Obese patients were then revaluated 6 months after surgery or after first evaluation. Parametric and non-parametric tests were applied as appropriate. RESULTS: On baseline, average age and body mass index on control group were 37.2 years and 27.4 kg/m2, and 42.1 years and 47.6 kg/m2 on obese patients. Seminal volume (2.9 vs. 1.5mL, p<0.0001), sperm concentration (82.7 vs. 69.8 mi/mL, p=0.0422), progressive motility (49.1 vs. 30.4%, p=0.0003), and Kruger morphology (3.3 vs. 1.9%, p = 0.0141) were lower in obese patients. Sexual hormones evaluation showed higher estradiol (24.1 vs. 33.4 pg/mL, p=0.0042), LH (4.3 vs. 6.4 IU/L, p = 0.0004) and FSH (3.8 vs. 6.1 IU/L, p = 0.006) serum values on obese patients, while testosterone (T) levels were 30% lower on obese patients (423.9 vs. 299.2 ng/dL, p = 0.0001). IIEF-5 score was not different between groups. On Phase 2, mean weight loss on patients submitted to bariatric surgery was 38.2 kg (95% CI 33.4 - 43). Group A1 patients showed after 6-month follow-up a decrease on sperm concentration (53.5 vs. 105.2mi/mL, p = 0.0572), total ejaculated sperm count (58.2 vs. 169.8 mi, p = 0.0098) and total motile sperm count (34.5 vs. 104 mi, p = 0.0036). On the other side, T levels (648.9 vs. 291.1 ng/dL, p < 0.0001) and free T levels (276.2 vs. 183.7, p < 0.0001) dramatically increased after surgery, while FSH, LH and estradiol were not different from baseline. On group A2, no differences were observed on seminal parameters and sexual hormones after follow-up. IIEF-5 score showed no significant changes on both groups. CONCLUSIONS: Obese patients have worse semen parameters, higher FSH, LH and estradiol levels, and lower T levels when compared to eutrophic fertile males. Bariatric surgery can increase T levels in 6-month follow-up; seminal parameters, however, may deteriorate after surgery. Source of Funding: None Sao Paulo, Brazil© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e765-e766 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Guilherme Wood* More articles by this author Bruno Tiseo More articles by this author Joao Paulo Cardoso More articles by this author Hamilton de Martin More articles by this author Marco Aurelio Santo More articles by this author Miguel Srougi More articles by this author Marcello Antonio Cocuzza More articles by this author Expand All Advertisement PDF downloadLoading ...
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bariatric surgery impact,erectile function,sexual hormones,semen parameters,surgery impact
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