ReviewCureus2026
Urological Complications of Morbid Obesity and the Role of Bariatric Surgery and Glucagon-Like Peptide-1 Receptor Agonists in Their Management: A Systematic Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- GLP-1 Receptor Agonists and Tirzepatide in Men Seeking Fertility: A Structured Narrative Review and Proposed Clinical Framework.Journal of clinical medicine · 2026Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Morbid obesity (body mass index (BMI) ≥40 kg/m² or ≥35 kg/m² with comorbidities) predisposes patients to multiple urological disorders, including urinary incontinence, overactive bladder, erectile dysfunction, hypogonadism, nephrolithiasis, obesity-related kidney disease, renal cell carcinoma, and aggressive prostate cancer. Bariatric surgery is the most effective durable treatment for severe obesity. Glucagon-like peptide-1 receptor agonists, including semaglutide and tirzepatide, have revolutionised obesity pharmacotherapy. This systematic review evaluates the urological complications of morbid obesity and the effects of bariatric surgery and glucagon-like peptide-1 receptor agonists on these outcomes. We searched MEDLINE, Embase, Scopus, and the Cochrane Library (January 2000 to June 2025) for studies reporting urological outcomes in adults with BMI ≥35 kg/m². Two reviewers independently screened and extracted data. We assessed risk of bias using the A Measurement Tool to Assess Systematic Reviews (AMSTAR) version 2 and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Eighty-four studies (>165,000 participants) met the inclusion criteria. Obesity increases renal cell carcinoma risk (relative risk: 1.5-2.0) and prostate cancer mortality (hazard ratio: 1.19-1.24) but paradoxically reduces prostate cancer incidence. Urinary incontinence and overactive bladder improve or resolve in 50-70% of women after bariatric surgery. Erectile dysfunction and hypogonadism improve after bariatric surgery, with International Index of Erectile Function (IIEF) scores increasing 4-6 points and testosterone rising 30-50%. Glucagon-like peptide-1 receptor agonists increase testosterone (standardised mean difference: 1.39 ng/mL) and improve erectile function. Tirzepatide reduces urinary albumin-to-creatinine ratio by 19-47% and preserves estimated glomerular filtration rate. Roux-en-Y gastric bypass increases nephrolithiasis risk 2.5-4-fold via enteric hyperoxaluria, whereas sleeve gastrectomy does not. Robot-assisted surgery in obese patients achieves complication rates comparable to those of non-obese patients after comorbidity adjustment. Bariatric surgery improves obesity-related urological morbidity, but Roux-en-Y gastric bypass increases stone risk. Glucagon-like peptide-1 receptor agonists offer a promising alternative with evidence for testosterone restoration, improved erectile function, and renal protection. Preoperative urological assessment, procedure selection, and multidisciplinary care are essential.
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