title: The impact of on-pump coronary artery bypass surgery vs. off-pump coronary artery bypass surgery on sexual function.
abstract: BACKGROUND
  Erectile dysfunction and ischemic heart disease are common health problems that affect elderly individuals. Despite advances in treatment strategies, cardiopulmonary bypass (CPB) has been used for coronary artery bypass grafting (CABG) for over three decades for surgical myocardial revascularization.
  
  
  OBJECTIVE
  To discuss the difference between the on pump and the newer alternative-the off-pump CABG (OPCABG) surgery-on the sexual function.
  
  
  METHODS
  This prospective study included 100 patients who underwent CABG.
  
  
  METHODS
  The patients were evaluated by an abridged form of International Index of Erectile Function questionnaire (IIEF-5), Pharmaco-Penile Duplex Ultrasound and finally by the European System for Cardiac Operative Risk Evaluation. The patients were underwent either on-pump CABG or OPCABG. Six months after surgery, the erectile function was revaluated according to the same preoperative measures.
  
  
  RESULTS
  Patients included in the study were classified into two matched groups: group I-patients who underwent on-pump CABG (N = 50); and group II-patients who underwent OPCABG (N = 50). The frequency of intercourse was significantly higher in OPCABG (P < 0.05) after surgery. The mean +/- standard deviation of the IIEF-5 scores of the on-pump group postoperatively became 12.48 +/- 7.19 whereas it became 15.88 +/- 6.67 in the off-pump group (P < 0.05). Moreover, the number of patients who reported postoperative improvement of their IIEF-5 score was significantly higher in OPCABG group (N = 23) compared with the conventional on-pump CABG group (N = 13) (P < 0.05). There was no significant change in the duplex ultrasound after surgery between both groups.
  
  
  CONCLUSIONS
  The OPCABG has a diminished impact on the sexual function of patients compared with the conventional on-pump CABG. Therefore, the type of operation can be considered a predictive factor of sexual function following CAB surgery.
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX, USA;. Electronic address: azimusama@gmail.com.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Mohamed
authors.affiliation: Greater Los Angeles VA Medical System, Los Angeles, CA, USA;; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Bennett
authors.affiliation: Andrology Department, Cairo University, Faculty of Medicine, Cairo, Egypt.
authors.forename: Mohamed Farid
authors.initials: MF
authors.lastname: Roaiah
authors.affiliation: Cardiothoracic Department, Cairo University, Faculty of Medicine, Cairo, Egypt.
authors.forename: Tarek
authors.initials: T
authors.lastname: Helmy
authors.affiliation: Andrology Department, Asyut University, Faculty of Medicine, Asyut, Egypt.
authors.forename: Ali
authors.initials: A
authors.lastname: Mahran
authors.affiliation: Cardiothoracic Department, Cairo University, Faculty of Medicine, Cairo, Egypt.
authors.forename: Hamed A
authors.initials: HA
authors.lastname: Hamed
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000601:surgery*; D011446:Prospective Studies; D011795:Surveys and Questionnaires