title: Significant improvement of erectile function after Roux-en-Y gastric bypass surgery in obese Chinese men with erectile dysfunction.
abstract: BACKGROUND
  We aimed to examine the effect of Roux-en-Y gastric bypass surgery (RYGB) on erectile dysfunction (ED), cavernosal morphological vasculopathy, and carotid wall alterations in severely obese Chinese men.
  
  
  METHODS
  We performed a retrospective cohort study of 39 obese men with ED who underwent RYGB between 2011 and 2012. Erectile function was assessed by the International Index of Erectile Function-5 (IIEF-5) before and 1 year after surgery. Intima-media thickness of carotid and cavernosal arteries and cavernosal peak systolic velocity (PSV) were investigated by color Doppler ultrasound. Endothelial function was assessed with the L-arginine test.
  
  
  RESULTS
  Eighteen (46.2%) men had cavernosal vasculopathy and 21 (53.8%) had carotid vasculopathy before surgery, and these proportions decreased to 15.4% and 23.1% after surgery, respectively. There was a significant improvement in carotid and cavernosal intima-media thickness postoperatively. IIEF-5 (17.3 to 23.8, P < 0.05), PSV (23 to 37, P < 0.05), and endothelial scores (6.1 to 8.2, P < 0.05) were all improved after RYGB. The increase in endothelial function scores was positively associated with changes in pre- to postoperative IIEF-5 scores (r = 0.438, P = 0.017). Younger age, being married, and lower preoperative IIEF-5 scores were independently related to greater improvement in erectile function.
  
  
  CONCLUSIONS
  ED can be relieved after RYGB in obese Chinese patients, accompanied by the improvement of cavernosal morphological vasculopathy and carotid wall alterations. Changes in endothelial function may contribute to this improvement, while preoperative body mass index and the amount of weight loss do not.
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600 Yishan Road, Xuhui District, Shanghai, 200233, China.
authors.forename: Li
authors.initials: L
authors.lastname: Kun
authors.forename: Zhang
authors.initials: Z
authors.lastname: Pin
authors.forename: Di
authors.initials: D
authors.lastname: Jianzhong
authors.forename: Han
authors.initials: H
authors.lastname: Xiaodong
authors.forename: Yu
authors.initials: Y
authors.lastname: Haoyong
authors.forename: Bao
authors.initials: B
authors.lastname: Yuqian
authors.forename: Zhang
authors.initials: Z
authors.lastname: Hongwei
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D004730:Endothelium, Vascular / Q000503:physiopathology; D007172:Erectile Dysfunction / Q000453:epidemiology* / Q000503:physiopathology; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult