Sexual dysfunction after elective endovascular or hand-assisted laparoscopic abdominal aneurysm repair

Area of Science:

• Vascular Surgery
• Minimally Invasive Surgery
• Sexual Health Outcomes

Background:

• Abdominal aortic aneurysm (AAA) repair aims to prevent rupture.
• Minimally invasive techniques like EVAR and HALS are increasingly used.
• Sexual dysfunction is a potential complication after AAA repair.

Purpose of the Study:

• To compare the incidence of sexual dysfunction and retrograde ejaculation after EVAR and HALS for AAA.
• To evaluate the impact of AAA repair techniques on erectile function and ejaculatory outcomes.

Main Methods:

• 100 patients undergoing elective infrarenal AAA repair were randomized to EVAR or HALS.
• Sexual function assessed using the International Index of Erectile Function (IIEF) preoperatively and at 12 months.
• Incidence of retrograde ejaculation was also recorded.

Main Results:

• No mortality at 1 or 12 months in either group.
• Erectile dysfunction incidence was 6% (EVAR) vs. 4% (HALS) (p=NS).
• Sexual function scores at 1 year were similar (EVAR: 66, HALS: 68; p=0.66). Retrograde ejaculation occurred in 3 HALS patients, none in EVAR.

Conclusions:

• Both EVAR and HALS demonstrate comparable sexual function outcomes post-AAA repair.
• HALS presents a minimally invasive option for sexually active males not suitable for EVAR.