Pierre Regnier1, Fabien Lareyre2, Réda Hassen-Khodja3, Matthieu Durand1, Joseph Touma4, Juliette Raffort5. 1. Department of Urology, University Hospital of Nice, Nice, France. 2. Department of Vascular Surgery, University Hospital of Nice, Nice, France; University of Côte d'Azur, CNRS, Inserm, IRCAN, France; Department of Vascular Surgery, Henri Mondor University Hospital, Créteil, France. Electronic address: fabien.lareyre@gmail.com. 3. Department of Vascular Surgery, University Hospital of Nice, Nice, France. 4. Department of Vascular Surgery, Henri Mondor University Hospital, Créteil, France. 5. University of Côte d'Azur, CNRS, Inserm, IRCAN, France; Clinical Chemistry Laboratory, University Hospital of Nice, France.
Abstract
BACKGROUND: Abdominal aortic aneurysm (AAA) represents a major health concern and the curative treatment relies on surgical approaches including open and endovascular aortic repair (EVAR). While epidemiological studies have addressed the major outcomes including mortality and life threatening complications, the impact of surgical intervention on sexual function has been less well described. The aim of this review was to summarise current knowledge on the occurrence of sexual dysfunction in the context of AAA surgical repair and to explore whether surgical techniques could have differential impact. METHODS: The MEDLINE database was searched in May 2017 and all studies related to sexual dysfunction assessment following AAA surgical repair were included. Given the heterogeneity of the definitions of sexual dysfunction and its assessment, a comprehensive literature review was performed rather than a meta-analysis. RESULTS: The published literature search identified 29 studies including prospective, retrospective, and single centre and multicentre trials. The post-operative erectile dysfunction prevalence varied from 7.4% to 79% following open repair and from 4.7% to 82% following EVAR. The incidence of de novo erectile dysfunction was estimated, respectively, at 20%, 26.6%, and 83% after open repair and at 11% and 14.3% after EVAR. Erectile dysfunction rates varied from 5.3% to 8.2% in patients who had EVAR with unilateral hypogastric artery exclusion and from 5.1% to 46.6% in patients who had bilateral hypogastric artery exclusion. The rates of retrograde ejaculation after surgery varied from 3.3% to 9% after open repair and from 6% to 6.6% after laparoscopic repair. CONCLUSION: Clinical studies demonstrated heterogeneous results, which could be attributed mainly to methodology including study design and criteria used to evaluate sexual dysfunction. Given the potential consequences of sexual dysfunction on quality of life, this review highlights the real need to inform patients and to better assess this potential side effect to improve its management in patients undergoing AAA surgical repair.
BACKGROUND:Abdominal aortic aneurysm (AAA) represents a major health concern and the curative treatment relies on surgical approaches including open and endovascular aortic repair (EVAR). While epidemiological studies have addressed the major outcomes including mortality and life threatening complications, the impact of surgical intervention on sexual function has been less well described. The aim of this review was to summarise current knowledge on the occurrence of sexual dysfunction in the context of AAA surgical repair and to explore whether surgical techniques could have differential impact. METHODS: The MEDLINE database was searched in May 2017 and all studies related to sexual dysfunction assessment following AAA surgical repair were included. Given the heterogeneity of the definitions of sexual dysfunction and its assessment, a comprehensive literature review was performed rather than a meta-analysis. RESULTS: The published literature search identified 29 studies including prospective, retrospective, and single centre and multicentre trials. The post-operative erectile dysfunction prevalence varied from 7.4% to 79% following open repair and from 4.7% to 82% following EVAR. The incidence of de novo erectile dysfunction was estimated, respectively, at 20%, 26.6%, and 83% after open repair and at 11% and 14.3% after EVAR. Erectile dysfunction rates varied from 5.3% to 8.2% in patients who had EVAR with unilateral hypogastric artery exclusion and from 5.1% to 46.6% in patients who had bilateral hypogastric artery exclusion. The rates of retrograde ejaculation after surgery varied from 3.3% to 9% after open repair and from 6% to 6.6% after laparoscopic repair. CONCLUSION: Clinical studies demonstrated heterogeneous results, which could be attributed mainly to methodology including study design and criteria used to evaluate sexual dysfunction. Given the potential consequences of sexual dysfunction on quality of life, this review highlights the real need to inform patients and to better assess this potential side effect to improve its management in patients undergoing AAA surgical repair.
Authors: Gianmarco de Donato; Edoardo Pasqui; Bruno Gargiulo; Giulia Casilli; Giulia Ferrante; Giuseppe Galzerano; Alessandro Cappelli; Giancarlo Palasciano Journal: Front Cardiovasc Med Date: 2022-02-28