Effects of bariatric surgery on male lower urinary tract symptoms and sexual function

To investigate the effect of bariatric surgery on male lower urinary tract symptoms (LUTS) and sexual function.

Fifty-five consecutive obese men who underwent a laparoscopic sleeve gastrectomy were prospectively enrolled. Two validated questionnaires, the International Prostate Symptoms Score (IPSS) and the International Index of Erectile Function (IIEF) were used to assess LUTS and sexual function, before and 3 months after surgery. Fifty-three men (mean age 39 ± 12.5 years) completed all pre and postoperative questionnaires. Mean body mass index (BMI) before and 3 months after surgery was 42.8 ± 5.3 and 31.3 ± 5.4 kg/m² ; respectively.

Preoperatively, 41 (77%) men (mean age 40 ± 12.9, mean BMI 42.2 ± 5 kg/m² ) had some degree of LUTS and 39 (74%) men (mean age 40.7 ± 12.4, mean BMI 42.8 ± 5.6 kg/m² ) were sexually active. Postoperatively, the total IPSS score decreased significantly (5.5 ± 4.4 vs. 2.7 ± 2.6; P < 0.001), however this change was due to improvement in storage phase LUTS, measured by questions 2, 4, and 7 of the IPSS questionnaire. No statistically significant changes of voiding phase LUTS, measured by questions 1, 3, 5, 6 of the IPSS, were observed. Of the various aspects of sexual dysfunction, only erectile function, measured by questions 1-5 and 15 of the IIEF questionnaire was significantly improved (22.7 ± 7.2 vs. 26.1 ± 6.5, P = 0.02). Postoperative overall intercourse satisfaction (9.5 ± 4.2 vs. 11.5 ± 3, P = 0.01) and overall satisfaction (7.9 ± 2.5 vs. 8.9 ± 1.3, P = 0.02) were significantly improved as well.

Male storage phase LUTS and erectile function were significantly and rapidly improved following bariatric surgery. Larger and long-term studies are required to investigate these apparently beneficial effects. Neurourol. Urodynam. 36:636-639, 2017. © 2016 Wiley Periodicals, Inc.