title: Prospective follow-up of sexual function after elective repair of abdominal aortic aneurysms using open and endovascular techniques.
abstract: OBJECTIVE
  Surgical intervention in the treatment of abdominal aortic aneurysms (AAA) can affect sexual functions, resulting in a negative impact on the quality of life. The aim of this study was to investigate the preoperative information given about sexual functions and to compare the functional changes after open (OR) and endovascular repair (EVAR) for patients with AAA during one year after treatment.
  
  
  METHODS
  Seventy-six patients participated in the study (40 OR and 36 EVAR). A questionnaire was used to measure the sexual function preoperatively, and then after one month and one year following surgical interventions. Four aspects related to sexual function were studied: interest in sex, quality of erection, ability to achieve orgasm, and ejaculation. Two questions about the preoperative information covering the sexual function and another two questions about the patients concern for their sexual activities were also added. Fisher's exact test was used to test for significant relative changes within each group of treatment for the variables studied.
  
  
  RESULTS
  Ninety-one percent reported that they did not receive any preoperative information about the risk for any possible negative impact on the sexual function. None of the EVAR patients were given such information. Forty-two percent of all patients felt some anxiety about having sex before the operation, which decreased to 7% after one year. About 22% reported having strong/moderate ability of their erection and 54% reported this as being weak/very weak preoperatively. Patients who preoperatively had reported some form of sexual interest had experienced a significant impairment in sex (P < .039) one year after the interventions. Patients treated with EVAR reported a significant impairment in the quality of erection (P < .033) and their ability to achieve ejaculation (P < .047) one year after the operation. A similar tendency was seen in the OR group, but did not achieve statistical significance.
  
  
  CONCLUSIONS
  Few patients were given or understood any preoperative information concerning the risk and possibility of a negative impact on their sexual function following surgical interventions. This was especially reported by patients in the EVAR group. Following the operation, the reported sexual interest and ability was decreased among patients in both groups. When only those patients who had reported some form of interest in sexual activity before the intervention were analyzed, a small significant impairment in quality of erection and achieving ejaculation could be found during the one year follow-up in the EVAR group.
authors.affiliation: Department of Vascular Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden. Monica.e.pettersson@vgregion.se
authors.forename: Monica
authors.initials: M
authors.lastname: Pettersson
authors.forename: Erney
authors.initials: E
authors.lastname: Mattsson
authors.forename: Ingegerd
authors.initials: I
authors.lastname: Bergbom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D032882:Comprehension; D004542:Ejaculation; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010410:Penile Erection; D011446:Prospective Studies; D018570:Risk Assessment; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000503:physiopathology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome