Effects of femorofemoral grafts on postoperative sexual function: correlation with penile pulse volume recordings

Twenty-four male patients underwent 24 femorofemoral bypass graft procedures for severely limiting claudication or limb threat. These patients were assessed for sexual function preoperatively and postoperatively. Twenty-three patients reported impotence preoperatively. Eighteen patients were studied with sequential penile pulse volume recording (PVRS), and in each case of impotence an abnormal penile PVR curve was noted. Seventeen of these 23 patients regained satisfying sexual function after femorofemoral bypass, and in most cases this correlated with an improved PVR curve. This study demonstrates the effectiveness of femorofemoral bypass in preserving and restoring erectile function. Neural injury is avoided, pelvic-directed blood flow established, and atheroembolism avoided. The status of postoperatively sexual function can be quantified by the penile pulse volume recorder, noting pulse amplitude and curve contour. Transducer standardization should be accomplished in vascular laboratories with local populations and known control subjects. Under these circumstances an abnormal PVR appears to be a permanent record of a reliable, reproducible test assessing insufficient penile perfusion. Improved sexual function after femorofemoral bypass can be correlated with increased pelvic perfusion demonstrated by an improvement in penile PVR tracings.