Influence of Gastric Bypass on Obese Women Sexual Function-a Prospective Study.

INTRODUCTION: Obesity may lead to hyperandrogenia and affect female sexual function. The study aims to evaluate female sexual function and androgenic profile in obese women after laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Forty obese women with a mean age of 34 years were prospectively studied. Diabetes and psychiatric and pelvic disorders were the exclusion criteria. All patients underwent LRYGB. Total (TT) and free (FT) testosterone, androstenedione (AD), dehydroepiandrosterone (DHEA) and the Sexual Quotient - Female Version were evaluated, preoperatively, 6 and 12 months after the operation. RESULTS: Preoperative incidence of sexual dysfunction was 10% and hyperandrogenia was 40%. At 6 months, sexual function was not different; and FT (0.49-0.33 ng/dl) and AD (2.0-1.3 ng/dl) decreased significantly. At 12 months, there was an improvement in female sexual function (77-84 points), related to desire and interest (22-25 points) and comfort (15.9-17.3 points) without case of sexual dysfunction at 12 months. Hyperandrogenia (40-8%), FT levels (0.5-0.3 ng/dl), and AD (2.0-1.4 ng/dl) decreased, while DHEA levels (3.4-4.2 ng/dl) increased. The percentage of weight loss was 22% and 31% at 6 and 12 months, respectively. Sexual function did not correlate with BMI, weight, or androgen levels in any period. CONCLUSION: Female sexual function in obese women with no diabetes and psychiatric and pelvic disorders improved in patients undergoing LRYGB, especially in desire, interest, and sexual comfort, and this occured after 6 months of the operation and unrelated to BMI, percentage of weight loss, or androgen levels. KEY POINTS: • In obese women with no diabetes and psychiatric and pelvic disorders the FSD improvement after LRYGB. • FSD no correlation with weight loss and BMI. • FSD no correlation with androgens levels.

Weight loss outcome after Roux-en-Y gastric bypass: 10 years of follow-up.

BACKGROUND: By submitting obese people to surgical treatment, we hope they lose weight and stay slim. Long-term monitoring is essential to assess effectiveness of surgery. This study aims to evaluate weight loss over 10 years in an obese population undergoing banded Roux-en-Y gastric bypass (B-RYGBP). METHODS: The surgery was performed in 211 obese between May 1999 and December 2000. This prospective study evaluated excess weight loss (%EWL) and body mass index (BMI) during the period. We considered surgical treatment failure if %EWL was less than 50 %. RESULTS: We followed 54.9 % of the population (116 patients). Patients' %EWL was 67.6 ± 14.9 % 1 year after surgery, 72.6 ± 14.9 % after 2 years, 69.7 ± 15.1 % after 5 years, 66.8 ± 7.6 % after 8 years, and 67.1 ± 11.9 % after 10 years postoperatively. Surgical treatment failure occurred in 16 patients (14.6 %) over 10 years. CONCLUSIONS: B-RYGBP is a good technique to promote and maintain weight loss 10 years after surgery with low failure rate.

Esophageal motility after laparoscopic Roux-en-Y gastric bypass: the manometry should be preoperative examination routine?

BACKGROUND: Our goal was to identify the changes of esophageal motility, lower esophageal sphincter (LES) function, and eating adaptation before and after Roux-en-Y gastric bypass (RYGBP) and whether manometry should be a routine examination in patients who undergo this procedure. METHODS: A total of 81 patients underwent manometry before surgery and 1 year after surgery. The control group consisted of 10 nonobese volunteers. Patients were classified as presenting with vomiting and without vomiting 1 year after surgery. Manometric variables were compared before and after surgery. Statistical analysis was performed using Wilcoxon and Mann-Whitney test. RESULTS: The patients (45.6%) had preoperative manometric findings, 29.8% had LES hypertonia, 18.9% LES hypotonia, 43.2% increase in wave amplitude of contraction, and three 8.1% abnormal peristalsis. One year after surgery manometry was abnormal in 62.9% of patients, 11.7% with hypertonia and 15.7% with hypotonia of the LES, 53% with changes in amplitude contraction and 19.6% with abnormal peristalsis. The control group showed no manometric abnormalities. Chronic vomiting was noted in 21% of patients. When comparing all variables between the pre and postoperative periods, there was no significant difference for all of them except for peristalsis. Comparing the results of manometric findings between the vomiting and non-vomiting groups, no significant changes were found in the variables studied. CONCLUSIONS: There was an association between RYGBP and motor abnormalities in the esophagus but no differences in postoperative feeding adaptation. Thus, we conclude that esophageal manometry is not necessary as a routine preoperative examination.