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Urología Colombiana
versão impressa ISSN 0120-789Xversão On-line ISSN 2027-0119
Urol. Colomb. vol.32 no.3 Bogotá jul./set. 2023 Epub 23-Abr-2024
https://doi.org/10.24875/ruc.23000012
Review article
Effects on the sex hormone profile in obese patients undergoing bariatric surgery
Efectos en el perfil hormonal sexual en pacientes obesos sometidos a cirugía bariátrica
1 Department of Research, FOSCAL Clinic; Bucaramanga, Santander, Colombia
2 Department of Urology, FOSCAL Clinic; Bucaramanga, Santander, Colombia
3 Universidad Autónoma de Bucaramanga. Bucaramanga, Santander, Colombia
We aimed to carry out a systematic review and meta-analysis of the effects of bariatric surgery on fertility in men with obesity. To assess the methodological quality of the included studies, the Cochrane-ROBINS-I tool for non-randomized studies was used. Three hundred and eighty-four articles were found. A statistically significant improvement in total testosterone levels was evidenced in all the patients; some studies did not find a correlation between this increase and the improvement in seminal parameters. Only one article showed a slight increase in estradiol levels (not statistically significant, 33.3-32 pg/mL, p: 0.68). Normal or low levels of LH and FSH were present both before and after the procedure. The total sperm count decreased at 6 months and was significantly lower at 12 months. There was not evidence of changes in seminal volume, sperm motility, and vitality. Although our systematic review shows changes on sexual hormonal parameters in men, with an increase in total testosterone levels, a negative one was also found on semen quality. More prospective and randomized studies are required, hopefully of the Latin American population, which can help confirm this association.
Keywords: Obesity; Bariatric surgery; Urology; Fertility; Hormones
Nuestro objetivo fue realizar una revisión sistemática y un metaanálisis de los efectos de la cirugía bariátrica sobre la fertilidad en hombres con obesidad. Para evaluar la calidad metodológica de los estudios incluidos, se utilizó la herramienta Cochrane-ROBINS-I para estudios no aleatorios. Se encontraron 384 artículos. Se evidenció una mejoría estadísticamente significativa en los niveles de testosterona total en todos los pacientes; algunos estudios no encontraron una correlación entre este aumento y cambios en los parámetros seminales. Solo un artículo mostró un ligero aumento en los niveles de estradiol (no estadísticamente significativo, 33,3 a 32 pg/ml, p: 0,68). Los niveles normales o bajos de LH y FSH estaban presentes tanto antes como después del procedimiento. El recuento total de espermatozoides disminuyó a los 6 meses y fue significativamente menor a los 12 meses. No hubo evidencia de cambios en el volumen seminal, la motilidad y la vitalidad de los espermatozoides. Aunque nuestra revisión sistemática muestra cambios sobre los parámetros hormonales sexuales en hombres, con un aumento de los niveles de testosterona total, también se encontró uno negativo sobre la calidad seminal. Se requieren más estudios prospectivos aleatorizados, ojalá en población latinoamericana, que ayuden a confirmar esta asociación.
Palabras clave: Obesidad; Cirugía bariátrica; Urología; Fertilidad; Hormonas
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Funding This research has not received any specific grants from agencies in the public, commercial, or for-profit sectors.
Ethical disclosuresProtection of human and animal subjects. The authors declare that no experiments were performed on humans or animals for this study. Confidentiality of data. The authors declare that no patient data appear in this article. Right to privacy and informed consent. The authors declare that no patient data appear in this article.
Received: January 24, 2023; Accepted: August 09, 2023
This is an open-access article distributed under the terms of the Creative Commons Attribution License
