Aorto-femoral reconstruction and sexual function: a prospective study.
The influence of aorto-femoral (AF) Dacron reconstruction on sexual function and pelvic circulation was studied prospectively in 62 male patients with aorto-iliac occlusive disease. Erectile function remained unchanged in 77%. Improvement or deterioration was seen in 11.3% and 20.5% of the cases respectively. Impotence occurred in only one patient (6%) with normal function preoperatively but in 31% of those presenting with impaired erection. Pelvic circulation, as reflected by the penile brachial index (PBI), was not affected in 74%, increased in 11% and decreased in 15% of the reconstructions. Pelvic circulation was at least preserved in 90% after an end-to-side proximal anastomosis and in 82% after an end-to-end anastomosis. Since fluctuations in sexual function could be related to changes in PBI in only 36% of the cases it is concluded that sexual disorders after AF surgery are due to a combination of disturbed pelvic haemodynamics and interruption of the preaortic autonomic plexus. Patients with impaired erectile function are especially at risk of a deterioration and the possibilities of restoring erectile function in patients with aorto-iliac stenosis by isolated AF reconstruction are limited.
Nevelsteen
A
A
Department of Vascular Surgery, University Clinic, St. Rafael-Gasthuisberg, Leuven, Belgium.
Beyens
G
G
Duchateau
J
J
Suy
R
R
D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D007172:Erectile Dysfunction / Q000209:etiology*; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply; D010410:Penile Erection / Q000502:physiology; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology
D011093:Polyethylene Terephthalates