Effect of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Male Sexual Function: A Systematic Review and Meta-Analysis

IF 7.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Obesity Reviews Pub Date : 2026-09-08 Epub Date: 2026-04-21 DOI:10.1111/obr.70136

Mohamed Hany, Mohamed H. Zidan, Hashem Altabbaa, Ahmed El Shamarka, Marwan Emad Abdou, Mohamed Al Sayed, Bart Torensma

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引用次数: 0

Abstract

Background

Obesity negatively impacts male sexual function and fertility through hormonal imbalances, endothelial dysfunction, and psychosocial factors. Metabolic and bariatric surgery (MBS) constitutes an effective intervention; however, procedure-stratified changes in male reproductive parameters after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remain incompletely synthesized.

Methodology

A systematic search of PubMed, Embase, Cochrane Library, Scopus, and Web of Science was conducted in November 2024. Sexual function, testosterone levels, and semen quality were included. Risk of bias was assessed using MINORS criteria. Random-effects meta-analyses were performed separately for each surgical modality, with heterogeneity quantified via I² statistics.

Results

Twenty-one studies comprising 848 patients were included. Meta-analysis of pre–post data demonstrated that both RYGB and SG were independently associated with improvements in sex hormone–binding globulin and testosterone levels. In studies examining SG, significant improvements were observed in erectile function (SMD: 1.38, 95% CI: 0.66–2.10, p = 0.0002) and sperm concentration (SMD: 0.91, 95% CI: 0.56–1.26, p < 0.00001). Studies evaluating RYGB did not demonstrate statistically significant changes in erectile function (SMD: 0.62, 95% CI: −0.06 to 1.30, p = 0.07) or sperm concentration (SMD: −0.01, 95% CI: −0.45 to 0.42, p = 0.95).

Conclusion

The meta-analytical findings suggest beneficial effects of both RYGB and SG on male hormonal parameters. Studies of SG demonstrated significant improvements in erectile function and sperm concentration. However, direct comparative analyses between the two procedures were not performed, precluding definitive conclusions regarding their relative efficacy. Future research necessitates head-to-head comparisons with standardized reproductive endpoints and extended follow-up periods.

查看原文本刊更多论文

Roux-en-Y胃旁路术和袖式胃切除术对男性性功能的影响：系统综述和meta分析。

背景：肥胖通过激素失衡、内皮功能障碍和心理社会因素对男性性功能和生育能力产生负面影响。代谢和减肥手术（MBS）是一种有效的干预措施；然而，Roux-en-Y胃旁路术（RYGB）和袖式胃切除术（SG）后男性生殖参数的手术分层变化仍然不完全综合。方法：系统检索PubMed， Embase, Cochrane Library， Scopus和Web of Science于2024年11月进行。性功能、睾丸激素水平和精液质量都包括在内。采用未成年人标准评估偏倚风险。对每种手术方式分别进行随机效应荟萃分析，通过I2统计量化异质性。结果：纳入21项研究，848例患者。前后数据的荟萃分析表明，RYGB和SG均与性激素结合球蛋白和睾酮水平的改善独立相关。在检查SG的研究中，观察到勃起功能（SMD: 1.38, 95% CI: 0.66-2.10, p = 0.0002）和精子浓度（SMD: 0.91, 95% CI: 0.56-1.26, p）有显著改善。结论：荟萃分析结果表明RYGB和SG对男性激素参数都有有益的影响。研究表明，SG对勃起功能和精子浓度有显著改善。然而，两种方法之间的直接比较分析没有进行，排除了关于其相对疗效的明确结论。未来的研究需要与标准化的生殖终点和延长的随访期进行面对面的比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Reviews 医学-内分泌学与代谢

CiteScore

19.30

自引率

1.10%

发文量

130

审稿时长

1 months

期刊介绍： Obesity Reviews is a monthly journal publishing reviews on all disciplines related to obesity and its comorbidities. This includes basic and behavioral sciences, clinical treatment and outcomes, epidemiology, prevention and public health. The journal should, therefore, appeal to all professionals with an interest in obesity and its comorbidities. Review types may include systematic narrative reviews, quantitative meta-analyses and narrative reviews but all must offer new insights, critical or novel perspectives that will enhance the state of knowledge in the field. The editorial policy is to publish high quality peer-reviewed manuscripts that provide needed new insight into all aspects of obesity and its related comorbidities while minimizing the period between submission and publication.