RESUMO
INTRODUCTION: Obesity is associated with erectile dysfunction in many studies. This study aims to inspect the impact of weight-loss surgery on the erectile function in the Saudi male population. PATIENTS AND METHODS: Forty-two consecutive male patients who underwent weight-loss surgery during a period from February 2013 to July 2016 were included in the study. Unmarried patients were excluded from the study. A designed questionnaire includes the short version of the International Index of Erectile Function (IIEF), usage of phosphodiesterase inhibitors, overall satisfaction before and after the intervention, marriage duration, and fertility postsurgery. All the participants were contacted through phone in July 2018, and then the questionnaire was mailed to them. All the data were analyzed and compared to a control group of married obese patients, who were waiting for the bariatric surgeries, using specific statistical tests. RESULTS: Thirty patients responded and completed the survey. Their mean age was 41.9 years (range 26-62), and the mean preoperative body mass index (BMI) was 46.3 ± 7.5, with a significant reduction in the BMI postoperatively to a mean of 30 ± 5.5. The IIEF score improved, and the overall satisfaction and feelings were better (76.7%). Only 16.7% of cases needed PDEI before and after the operation. Thirteen (43.3%) patients got children after the surgery. Univariate and multivariate analysis showed that age was a significant factor in association with both erectile function and fertility after bariatric surgeries (P = 0.02). Fertility was better in patients who underwent laparoscopic sleeve gastrectomy than gastric bypass surgery (P = 0.01). CONCLUSION: The weight-loss surgeries have a significant effect on erectile function, and they improve patient sexual satisfaction. Most of these patients feel better sexual function after bariatric surgeries. Fertility outcome seems to have a positive correlation with this type of surgery. However, a larger sample size and more elaborate studies are warranted to substantiate this claim.
RESUMO
BACKGROUND: Approximately 2-10% of patients with varicocele complain of pain. Varicocelectomy for testicular pain is a surgical choice when conservative therapy fails to relieve the pain. Different variables have been reported as prognostic factors for pain relief following varicocele ligation. Moreover, the success rate of varicocelectomy for testicular pain has varied among studies. This retrospective study aimed to investigate the predictors and success rate of microscopic subinguinal varicocelectomy performed for the treatment of painful varicocele. RESULTS: Among the 132 patients, 83.3% reported pain relief. A significant association was identified between varicocelectomy for unilateral testicular pain and pain resolution (P < 0.0001); no other factors were predictors of pain relief. CONCLUSIONS: Microscopic subinguinal varicocelectomy for testicular pain is an effective surgical alternative. Varicocelectomy for unilateral testicular pain may predict postoperative pain relief in appropriately selected patients.
RéSUMé: CONTEXTE: Environ 2 à 10 % des patients porteurs de varicocèle se plaignent de douleur. La varicocèlectomie pour douleur testiculaire est un choix chirurgical lorsque le traitement conservateur ne parvient pas à soulager la douleur. Différentes variables ont été rapportées comme facteurs pronostiques du soulagement de la douleur après ligature de la varicocèle. Par ailleurs, le taux de réussite de la varicocèlectomie pour douleur testiculaire varie selon les études. Cette étude rétrospective visait à étudier les facteurs prédictifs et le taux de réussite de la varicocèlectomie subinguinale microscopique réalisée pour traiter une varicocèle douloureuse. RéSULTATS: Parmi les 132 patients opérés, 83,3% ont rapporté le soulagement de la douleur. Une association significative a été identifiée entre la varicocèlectomie pour douleur testiculaire unilatérale et la résolution de la douleur (P <0,0001) ; aucun autre facteur n'était prédictif du soulagement de la douleur. CONCLUSIONS: La varicocèlectomie subinguinale microscopique pour douleur testiculaire est une alternative chirurgicale efficace. La varicocèlectomie pour douleur testiculaire unilatérale peut prédire le soulagement postopératoire de la douleur chez les patients convenablement choisis.
