Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202400142
Jornal Vascular Brasileiro
Artigo Original

Sexual effects and long-term outcomes of endoscopic lumbar sympathectomy for plantar hyperhidrosis in men: a cross-sectional study

Efeitos sexuais e resultados a longo prazo da simpatectomia lombar endoscópica para hiperidrose plantar em homens: um estudo transversal

Marcelo de Paula Loureiro; Pietro Maran Novais; Ruimário Machado Coelho; João Augusto Nocera Paulin

http://dx.doi.org/10.1590/1677-5449.202400142 J Vasc Bras, vol.23, e20240014, 2024
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Abstract

Background: Plantar hyperhidrosis (PHH) is a disease with high psychosocial impact, and endoscopic lumbar sympathectomy (ELS) has been shown to be the best choice for treatment, but with some concerns such as compensatory sweating (CS) and sexual effects (SE), particularly in men.

Objectives: The aim of this study is to evaluate the long-term effectiveness of ELS for controlling PHH in men, its side effects, and perceived sexual modifications.

Methods: A cross-sectional study including only male patients operated for PHH with ELS between 2014–2022 at a private practice. During remote interviews, patients were asked about symptoms before and after ELS and about the postoperative effects on PHH. They were also objectively asked about any SE during the postoperative period. Validated quality of life for hyperhidrosis and erectile function questionnaires were also administered.

Results: 10 male patients averaging 4.26±2.86 years post-ELS were interviewed. Eight of them (80%) achieved complete response (≥80% of sweat reduction) in the first month after surgery and this response was maintained up to the interview date. Two patients had partial response. In six patients, CS occurred, with 5 reporting it as non-troublesome. Six patients reported some type of SE, but none reported erectile dysfunction. Regarding the functional results, all patients rated ELS from good (10%) to very good (30%) or excellent (60%).

Conclusions: Endoscopic lumbar sympathectomy was effective for treatment of plantar hyperhidrosis in these patients, improving their quality of life and providing lasting PHH control, with some transient sexual dysfunctions that did not impair their sexual life.

Keywords

endoscopic lumbar sympathectomy, retroperitoneal space, erectile dysfunction, sexual health, male, plantar hyperhidrosis

Resumo

Contexto: A hiperidrose plantar (HHP) é uma doença de alto impacto psicossocial, e a simpatectomia lombar endoscópica (SLE) tem se mostrado a melhor escolha de tratamento. Porém, há algumas preocupações como suor compensatório (SC) e efeitos sexuais (ES), particularmente em homens.

Objetivos: O objetivo deste estudo foi avaliar a eficácia a longo prazo da SLE para controlar a HHP em homens, seus efeitos colaterais e as modificações sexuais percebidas.

Métodos: Tratou-se de um estudo transversal incluindo apenas pacientes do sexo masculino operados de HHP por meio de SLE entre 2014 e 2022 em consultório particular. Por meio de entrevistas remotas, os pacientes foram questionados sobre os sintomas antes e depois da SLE e sobre a evolução pós-operatória da HHP, assim como foram questionados objetivamente sobre qualquer ES percebido durante o pós-operatório. Também foram aplicados questionários validados de qualidade de vida para hiperidrose e função erétil.

Resultados: Foram entrevistados 10 pacientes do sexo masculino com média de 4,26±2,86 anos pós-SLE. Oito deles (80%) obtiveram resposta completa (≥80% de redução do suor) no primeiro mês após a cirurgia e mantiveram a resposta na entrevista. Dois pacientes tiveram resposta parcial. Em seis pacientes, ocorreu SC, com cinco relatando-a como não problemática. Seis pacientes relataram algum tipo de ES, mas nenhum apresentou disfunção erétil. Todos os pacientes avaliaram o resultado funcional da SLE como bom (10%), muito bom (30%) ou excelente (60%).

Conclusões: A SLE pode tratar de forma eficaz a HHP nesses pacientes, melhorando a qualidade de vida e proporcionando efeitos duradouros no controle da HHP, com algumas disfunções sexuais transitórias que não prejudicam a vida sexual.

Palavras-chave

simpatectomia lombar endoscópica, espaço retroperitoneal, disfunção erétil, saúde sexual, masculino, hiperidrose plantar

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Submetido em:
14/02/2024

Aceito em:
13/05/2024

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