Endocrine Abstracts

Objective: The aim of this meta-analysis is to evaluate the effect of bariatric surgery on sexual function and sex hormone levels in obese patients.

Methods: Two independent investigators conducted a literature search of PubMed, Medline and Cochrane databases using the terms bariatric surgery, sexual function and sex hormone to identify appropriate human studies published in English about the effect of bariatric surgery on sexual function and sex hormone levels in obese patients. The search was restricted to data from January 1, 1990 to December 1, 2016. Bibliographies of recent review articles and systematic reviews were searched to identify any additional trials. Two investigators according to the inclusion and exclusion criteria independently select literature, extract data and evaluate quality, then using RevMan 5.3.5 software for Meta analysis.

Results: In all, 31 studies met all criteria, including 1150 patients. The types of bariatric surgery performed included laparoscopic Roux-en-Y gastric bypass, laparoscopic gastric banding surgery, laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric banding, vertical gastric banding, biliopancreatic diversion. The time to follow-up after surgery varied from 1 months to 115 months. Of the 31 studies, 5 reported the IIEF in obese men in 154 of 1150 patients (MD=4.84, 95%CI (2.92, 6.75), P<0.00001); 7 studies reported the FSFI in obese women in 369 of 1150 patients (MD=4.10, 95%CI (−0.28, 8.48), P=0.07). The changes of sex hormone levels in obese male patients before and after bariatric surgery as following: total testosterone (MD=8.55, 95%CI (6.59, 10.52), P<0.00001); free testosterone (MD=6.52, 95%CI (3.09, 9.94), P=0.0002); estradiol (MD= −7.03, 95%CI (−11.05, −3.01), P=0.0006); luteinizing hormone (MD=0.92, 95%CI (0.64, 1.20), P<0.00001); follicle-stimulating hormone (MD=1.29, 95%CI (0.65, 1.94), P<0.0001); sex hormone-binding globulin (MD=23.85, 95%CI (18.44, 29.26), P<0.00001). The changes of sex hormone levels in obese female patients before and after bariatric surgery as following: total testosterone (MD=−0.78, 95%CI (−0.84, −0.71), P<0.00001); free testosterone (MD=−5.53, 95%CI (−10.47, −0.59), P=0.03); estradiol (MD=−25.10, 95%CI (−36.92, −13.27), P<0.0001); luteinizing hormone (MD=4.50, 95%CI (−1.04, 10.05), P=0.11); follicle-stimulating hormone (MD=1.68, 95%CI (0.50, 2.86), P=0.005); sex hormone-binding globulin (MD=34.79, 95%CI (22.63, 46.96), P<0.00001).

Conclusion: This meta-analysis indicates that bariatric surgery has a significant improvement on the sexual function in both genders.