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The median interval between the bariatric procedure and the initiation of pharmacological treatment was 5 years (IQR: 27 years)

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The activation of the AGE-RAGE axis amplifies chronic inflammation and oxidative stress in both microenvironments, while SNS overactivity and elevated catecholamines induce vasoconstriction in both testicular and penile vasculature, forming a vicious cycle of sympathetic activation and inflammatory damage (207)

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