Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202301352
Jornal Vascular Brasileiro
Original Article

Sexual dysfunction after open abdominal aortic aneurysm repair: 16 years’ experience in a quaternary center and literature review

Disfunção sexual após correção aberta de aneurisma da aorta abdominal: 16 anos de experiência em um centro quaternário e revisão da literatura

Bruno Pagnin Schmid; Marcelo Vezzi Muce; Rodrigo Gonzalez Bocos; Fábio Hüsemann Menezes

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Abstract

Background: Open abdominal aortic aneurysm (AAA) repair can lead to sexual dysfunction (SD) in men.

Objectives: To determine the prevalence of SD following open AAA repair, explore whether surgical techniques for aortic reconstruction can have a differential impact on the occurrence of SD, and summarize current knowledge in this field.

Methods: Retrospective review of 100 patients submitted to open AAA repair between 1995 and 2010 in a quaternary center. Sexual dysfunction was assessed according to questions from the modified International Index of Erectile Function (IIEF), considering the condition before surgical repair and 3 months after surgery. The chi-square test, Fisher’s exact test, and Student’s t test were used for statistical analyses.

Results: 100 patients were included (mean age = 66.4 years old). Normal sexual activity, no sexual activity, erectile dysfunction, and retrograde ejaculation with preserved erectile function were found in 36%, 21%, 18%, and 24% of patients, respectively. The group of patients with no sexual activity was older (mean age = 72.3 years old vs 64.5 years old, p < 0.001). Erectile dysfunction prevalence was higher in patients submitted to an aorto-bifemoral bypass (p = 0.032). Retrograde ejaculation was more frequent in patients submitted to an aorto-aortic bypass (p = 0.007).

Conclusions: Sexual function is a frequent condition intimately associated with the aortic reconstruction technique. The literature review found contradictory results regarding whether the endovascular approach is protective compared with open repair, but clearly demonstrated the importance of techniques targeting preservation of the internal iliac artery and the superior hypogastric plexus.

Keywords

aneurysm, erectile dysfunction, ejaculation

Resumo

Contexto: A correção aberta de aneurisma da aorta abdominal (AAA) pode causar disfunção sexual (DS) em homens.

Objetivos: Determinar a prevalência de DS após correção aberta de AAA, determinar se a técnica de reconstrução aórtica pode estar correlacionada com o surgimento de DS e resumir os achados mais relevantes da literatura relacionados a esse tema.

Métodos: Estudo retrospectivo de todos os pacientes submetidos a correção aberta de AAA entre 1995 e 2010 num centro quaternário. A DS foi avaliada por meio de questões baseadas no escore International Index of Erection Function no pré-operatório e 3 meses após a cirurgia. A análise estatística foi realizada com os testes do qui-quadrado, exato de Fisher e t de Student.

Resultados: Cem pacientes foram incluídos (idade média = 66.4 anos). Atividade sexual normal, atividade sexual ausente, disfunção erétil (DE) e ejaculação retrógrada (ER) com função erétil preservada foram observadas em 36%, 21%, 18% e 24% dos pacientes, respectivamente. O grupo de pacientes com atividade sexual ausente foi significativamente mais velho (idade média = 72.3 anos vs. 64.5 anos, p < 0.001). A DE foi mais prevalente em pacientes submetidos a enxerto aorto-bifemoral (p = 0.032), enquanto a ER foi mais prevalente em pacientes submetidos a enxerto aorto-aórtico (p = 0.007).

Conclusões: A DS é uma condição frequente e intimamente associada à reconstrução aórtica empregada. A literatura apresenta resultados contraditórios sobre qual correção de AAA (aberta ou endovascular) resulta em mais DS, mas demonstra a importância de técnicas com preservação das artérias hipogástricas e do plexo hipogástrico superior.
 

Palavras-chave

aneurisma, disfunção erétil, ejaculação

References

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Submitted date:
09/08/2023

Accepted date:
11/08/2023

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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