(701) Preoperative Assessment of Male Sexual Function in Bariatric Surgery

Abstract Introduction Obesity is a prevalent condition linked with multiple comorbidities including diabetes, hypertension, and metabolic syndrome, all of which negatively impact quality of life and male sexual function. Men with obesity have a higher prevalence of erectile dysfunction (ED) compared to non-obese men, due to psychological factors (e.g., low self-esteem) and physiological mechanisms such as chronic inflammation, endothelial dysfunction, and hormonal imbalances fincluding decreased testosterone. Bariatric surgery is an established intervention for sustained weight loss and improvement of metabolic comorbidities, but limited data exist on its baseline impact on sexual function in obese men Objective To characterize the baseline prevalence and severity of erectile and sexual dysfunction in obese male candidates for bariatric surgery using validated sexual health assessments and to explore associations between sexual function and clinical, hormonal, and anthropometric parameters Methods The cohort of patients consists of male patients from a single medical center who are scheduled for bariatric surgery between January and June 2025. Men are non-randomly and consecutively enrolled. Inclusion criteria include men between 18 and 65 years old and indication for bariatric surgery. Exclusion criteria include non-obesity-related causes of ED and use of phosphodiesterase inhibitors. Eligible patients are prospectively evaluated at the baseline (pre-operative consultation) by validated questionnaires (International Index of Erectile FunctionIIIEF), anthropometric measurements (weight, height, body max index (BMI), neck, breast and waist circumferences) and biochemical tests assessing metabolic and hormonal markers (heamoglobin A1c (HbA1c), glucose, c-reactive protein (CRP), free testosterone, prolactin, lipids). Preoperative demographic data are also collected. Statistical analysis is performed using SPSS version 29. Descriptive statistics are used to summarize the characteristics of the study population. Correlations between baseline variables and IIEF total and domain scores are analyzed using Pearson/Spearman tests and multivariate linear regression. A p-value of 0.05 is considered statistically significant. Results A total of 81 patients were initially screened, of whom 67 were included in the final analysis: 14 patients were excluded due to their refusal to undergo surgery or lack of surgical indication. The mean age was 44.8 years, 62.2% had basic or secondary education, 61.5% of the patients were married. The median BMI was 40.9 kg/m2. ED severity distribution showed 61.3% had no ED and 38.7% had mild to severe ED. Age was negatively correlated with total IIEF score and specific domains (erectile, orgasmic, sexual desire, intercourse satisfaction; p0.05). HbA1c was negatively correlated with erectile and orgasmic function (p=0.01–0.02). Multivariate analysis revealed that increased CRP predicted lower orgasmic function (p=0.027), while higher prolactin and older age were associated with decreased intercourse satisfaction (p=0.009 and p=0.021, respectively). Conclusions This study demonstrates a high prevalence of sexual dysfunction among obese men eligible for bariatric surgery. Key determinants include age, glycaemic control, inflammation, and hormonal status. Emerging associations involving CRP and prolactin highlight inflammatory and endocrine factors as potential therapeutic targets to improve sexual function in this population. These baseline findings are part of a larger ongoing study aiming to evaluate the effect of bariatric surgery on sexual function in men Disclosure No