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Gastric Bypass Surgery Shows Secondary Benefits

May 22, 2008 (Orlando, Florida) — Losing weight can help resolve erectile dysfunction in obese men, according to findings presented here at the American Urological Association (AUA) 2008 Annual Meeting.

Morbid obesity can cause sexual dysfunction independent of other common confounders, including diabetes, hypertension, and smoking. In this study, from researchers in Boston and Philadelphia, sexual function was normalized in some men who underwent gastric bypass surgery for weight loss.

"This study shows that weight loss and other risk factors that are alleviated by weight loss may be keys to restoring sexual function," said Anthony Y. Smith, MD, from the University of New Mexico, in Albuquerque, a member of the AUA Public Media Committee who was not involved with the presentation. "These results give men another reason to improve their health by losing weight."

Gastric bypass surgery, a procedure that reduces the body's caloric intake, can be used to induce significant weight loss in the obese. Calorie reduction is accomplished by making the stomach smaller and bypassing part of the stomach and small intestines so that fewer calories are absorbed. The patient feels full faster and learns to reduce the amount of food eaten.

In the study, 95 patients undergoing gastric bypass surgery for weight loss completed the Brief Sexual Inventory (BSI) pre- and postoperatively. The mean age of the group was 47.9 years (ranger, 19–70 years) and the mean body mass index was 51.2 kg/m² (range, 36–89 kg/m²). No one in the group was taking a phosphodiesterase type 5 inhibitor.

On average, after a mean postoperative follow-up of 19 months (range, 2–45 months), BSI scores improved in all areas (P < .0005): sexual-drive scores (range, 0–8) rose from 3.9 ± 0.3 to 5.4 ± 0.3; erectile-function scores (range, 0–12) rose from 6.3 ± 0.5 to 8.9 ± 0.5; ejaculatory-function scores (range, 0–8) rose from 4.9 ± 0.4 to 6.3 ± 0.4; problem-assessment scores (range, 0–12) rose from 7.4 ± 0.5 to 9.5 ± 0.6; and sexual-satisfaction scores (range, 0–4) rose from 1.6 ± 0.2 to 2.2 ± 0.2. The amount of weight lost predicted the degree of improvement in all areas of the survey (P < .002). Age and the presence of diabetes, hypertension, and smoking were all controlled for.

These data were compared with data from the Olmstead County Study of Urinary Health Status Survey, a community-based prospective study often used as a baseline for study comparison. After an average postbypass weight loss of 67%, BSI scores were comparable to those of patients in the Olmstead study.

"The findings were remarkable,'' Ramsey Dallal, MD, director of Einstein Bariatrics in Philadelphia, Pennsylvania, told Medscape Urology. "First, the amount of sexual dysfunction in morbidly obese men was rather profound. And surprisingly, it's quite reversible. For most patients, they can obtain the same sexual function as a normal matched-age male."

The researchers have disclosed no relevant financial relationships.

American Urological Association (AUA) 2008 Annual Meeting: Abstract 1178. Presented May 19, 2008.