Does Significant Weight Loss After Bariatric Surgery Affect Sexual Function and Urinary Symptoms? An Iranian Study.

INTRODUCTION: For sexual dysfunction and lower urinary tract symptoms (LUTS), obesity is identified as an independent risk factor. The current study aimed to evaluate the effect of significant rapid weight loss by bariatric surgery on LUTS and sexual function among men and women with class III obesity. METHOD: A group of patients who were planned to undergo bariatric surgery was enrolled in the study. Male patients were given the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS) questionnaires. In the female group, they filled in the female sexual function index (FSFI) and the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) questionnaires. Patients were followed up 1 year after their bariatric surgery. RESULTS: All questionnaires were completed by eighty-one patients. (mean age ± SD: 39.4 ± 9.2 years; mean body mass index (BMI) ± SD: 47.15 ± 5.4 kg/m2). The total score of the IPSS questionnaire decreased from 5.83 ± 3.01 preoperatively to 2.37 ± 1.66 postoperatively. The weight loss caused significant improvement in the storage phase of LUTS domains, but there were no considerable changes in the voiding phase. In the IIEF questionnaire, domains of sexual desire, overall satisfaction, and orgasmic function improved significantly. There was not a significant change in any FSFI domains after bariatric surgery. Mean ICIQ-SF decreased, but it was not substantial. CONCLUSION: Bariatric surgery can significantly improve the storage phase in men, but not the voiding phase. Sexual desire, orgasmic function, and overall satisfaction were significantly improved in men. No significant improvement in sexual function and UI in women was observed.

Assessment of the relationship between vitamin D with semen analysis parameters and reproductive hormones levels before and after kidney transplantation: An Iranian randomized and double-blinded study.

BACKGROUND: Vitamin D's role is noticeable on homeostasis of calcium and phosphorous and bone mineralization. Some studies prove that vitamin D has a role in reproductive pathways in male and females and its direct relationship with serum androgen levels in males. The common problem of infertility can be seen in 10%-15% of couples. 25%-50% of all infertilities is due to a male factor, and fertility disturbances are common in male CKD patients. OBJECTIVES: This study aimed to figure out the effect of serum vitamin D levels on semen analysis parameters and reproductive hormones before and after renal transplantation in ESRD patients. METHODS: This double-blind randomized clinical trial was carried out on 70 ESRD males (21-48 years old) who were candidates for renal transplantation at Sina hospital between 2021 and 2022. Participants were divided into two groups randomly. First group was supplemented by vitamin D (50,000 units weakly until 3 months), and no intervention was done in the second group. Vitamin D levels, LH, FSH, creatinine, glomerular filtration rate (GFR), calcium, total and free testosterone, PTH, sexual function, and semen analysis parameters were evaluated in a determined interval before and after (three and 6 months) kidney transplantation. RESULTS: Vitamin D levels were noticeably higher in case group in comparison to the control group (p-value < 0.01) but the difference in all other variables including calcium levels, LH, FSH, total and free testosterone, IIEF-5 score, PTH, GFR, and creatinine was insignificant (p-value > 0.05). The comparison of semen parameters of the case with control group including sperm count, morphology, volume, and motility didn't reveal a noticeable difference between the two groups (p-value > 0.05). CONCLUSION: Prescription of vitamin D as a supplementation doesn't improve sperm quality (sperm count, motility, morphology, and volume) and reproductive hormones (LH, FSH, free and total testosterone) after kidney transplantation in male CKD patients.