Elimination of iatrogenic impotence and improvement of sexual function after aortoiliac revascularization.
One hundred ten men who underwent revascularization for aortoiliac occlusive disease by either aortic reconstruction (n = 66), crossover femorofemoral bypass (n = 38), or axillofemoral bypass (n = 6) were examined with regard to preoperative and postoperative sexual function. Aortic reconstructions were performed using a nerve-sparing technique, and special emphasis was placed on preservation or improvement of pelvic blood supply. Thirty patients (27%) were impotent preoperatively and postoperatively, 67 patients (61%) had normal sexual function preoperatively and postoperatively, and 13 patients (12%) who were impotent preoperatively regained sexual function as a result of revascularization, indicating that 30% (13/43) of all patients with preoperative impotence regained sexual function. No patient with normal preoperative sexual function was impotent postoperatively. Nerve-sparing aortic dissections, attention to preservation or improvement of pelvic blood flow, and, when appropriate, extra-anatomic bypass are essential in the preservation or improvement of sexual function after aortoiliac revascularization.
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery; D007172:Erectile Dysfunction / Q000209:etiology*; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*