Elimination of iatrogenic impotence and improvement of sexual function after aortoiliac revascularization
D. P. Flanigan, J. J. Schuler, T. Keifer, J. A. Schwartz and L. T. Lim
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.
