Sexual Dysfunction After Abdominal Aortic Aneurysm Surgical Repair: Current Knowledge and Future Directions

Area of Science:

• Vascular Surgery
• Urology
• Sexual Medicine

Background:

• Abdominal aortic aneurysm (AAA) repair is crucial for patient survival.
• The impact of AAA surgical repair on sexual function remains under-described.
• Existing studies focus on mortality and major complications, neglecting sexual health outcomes.

Purpose of the Study:

• To review current knowledge on sexual dysfunction after AAA surgical repair.
• To explore potential differences in sexual dysfunction rates between open repair and EVAR.
• To highlight the need for improved patient counseling and assessment.

Main Methods:

• Comprehensive literature search of MEDLINE database (May 2017).
• Inclusion of all studies assessing sexual dysfunction post-AAA surgical repair.
• Qualitative literature review due to heterogeneity in assessment methods; meta-analysis not performed.

Main Results:

• Erectile dysfunction prevalence varied widely (7.4%-79% open repair, 4.7%-82% EVAR).
• De novo erectile dysfunction incidence ranged from 11% to 83% across repair types.
• Retrograde ejaculation rates were reported between 3.3%-9% (open) and 6%-6.6% (laparoscopic).
• Hypogastric artery exclusion in EVAR influenced erectile dysfunction rates.

Conclusions:

• Heterogeneous results in clinical studies are likely due to methodological variations.
• Sexual dysfunction significantly impacts quality of life post-AAA repair.
• There is a critical need for standardized assessment and patient education regarding sexual side effects.