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

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. I(2) 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. Xu J, Wu Q, Zhang Y, et al. Effect of Bariatric Surgery on Male Sexual Function: A Meta-Analysis and Systematic Review. Sex Med 2019;7:270–281.