RESUMO
Morbid obesity is associated with a large number of complications, including infertility; weight loss can help to improve fertility and increase the number of sperm in males. However, two of our patients developed azoospermia after bariatric surgery for weight reduction. A 30-year-old male presented to the outpatient department (OPD) with a BMI of 81.2 kg/m2 (258 kg) with no known co-morbidities. The patient had a normal sex life and one child. After bariatric surgery, he noticed a change in the consistency of his semen and azoospermia. In the second case, a 48-year-old man presented to the OPD with a BMI of 52 kg/m2 (189 kg) with no known co-morbidities. He had three children. He underwent bariatric surgery for weight loss and, after one year, he developed azoospermia. Bariatric surgery is a lifesaving procedure for morbidly obese patients and helps in restoring normal daily activities. This weight reduction surgery helps in decreasing blood pressure, increasing glycemic control and improving sexual activity. However, bariatric surgery may be followed by a further decline in semen parameters, resulting in azoospermia and severe oligoasthenoteratozoospermia. This is caused by the combined effects of two different processes: 1) the subduing of the negative effects of obesity, and 2) a deficiency of nutrients along with the release of some harmful substances. Bariatric surgery patients should be informed about the risk of complications and about the possibility for cryopreservation of sperm. In rare cases, bariatric surgery can result in a decrease in sperm count and infertility in males.
RESUMO
Objective To assess the outcome and safety of staple line over-sewing for patients undergoing laparoscopic sleeve gastrectomy (LSG). Study design and location Retrospective descriptive analysis conducted at Shifa International Hospital Islamabad. Materials and methods Consecutive patients undergoing LSG as a treatment for morbid obesity from October 2013 to December 2016 were included in the study after approval from the ethical review board. Patients were divided into two groups: group A who underwent reinforcement using Vicryl 2.0 and group B where no reinforcement was done. Results A total of 225 patients underwent LSG between October 2013 and December 2016, including 147 females (65.4%) and 78 males (34.6%). Both groups were comparable in terms of age, body mass index (BMI) and gender distribution (p-value more than 0.05). There was one leak in group A (1.36%), none in group B. The bleeding rate was 4.3% in group A and 2.7% in group B. Conclusion This was a retrospective analysis of all the patients who underwent LSG, and it was observed that there was no added benefit of sewing the staple line in terms of rate of bleeding and leak.
