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Published on: March 27, 2018
The impact of on-pump coronary artery bypass surgery vs. off-pump coronary artery bypass surgery on sexual function
Osama A Mohamed1, Carol J Bennett2, Mohamed Farid Roaiah3
1Department of Urology, Baylor College of Medicine, Houston, TX, USA;.
Insights
Off-pump coronary artery bypass grafting (OPCABG) surgery positively impacts sexual function more than on-pump CABG. OPCABG is a better choice for maintaining erectile function after cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Urology
- Geriatric Medicine
Background:
- Erectile dysfunction (ED) and ischemic heart disease are prevalent in the elderly.
- Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) has been a standard treatment for decades.
- Advances in surgical techniques aim to improve patient outcomes, including quality of life.
Purpose of the Study:
- To compare the impact of on-pump versus off-pump CABG (OPCABG) on patient sexual function.
- To evaluate changes in erectile function following different CABG procedures.
Main Methods:
- A prospective study involving 100 patients undergoing CABG.
- Patients were assessed preoperatively and six months postoperatively using the International Index of Erectile Function (IIEF-5) questionnaire and Pharmaco-Penile Duplex Ultrasound.
- Participants were divided into two groups: on-pump CABG (N=50) and OPCABG (N=50).
Main Results:
- The OPCABG group demonstrated a significantly higher frequency of intercourse post-surgery (P < 0.05).
- Mean IIEF-5 scores improved significantly in the OPCABG group (15.88 ± 6.67) compared to the on-pump group (12.48 ± 7.19) (P < 0.05).
- More patients in the OPCABG group reported improved IIEF-5 scores (N=23) versus the on-pump group (N=13) (P < 0.05); duplex ultrasound showed no significant changes.
Conclusions:
- OPCABG has a less negative impact on sexual function compared to conventional on-pump CABG.
- The surgical approach (on-pump vs. off-pump) is a significant factor influencing sexual function recovery after CABG surgery.
Introduction:
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.
Aim:
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.
Main Outcome Measures:
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.
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