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Elimination of Iatrogenic Impotence and Improvement of Sexual Function After Aortoiliac Revascularization

D. Preston Flanigan, MD; James J. Schuler, MD; Teresa Keifer, RN; John A. Schwartz, MD; Leonardo T. Lim, MD
Arch Surg. 1982;117(5):544-550. doi:10.1001/archsurg.1982.01380290016004.
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• One hundred ten men who underwent revascularization for aortoiliac occlusive disease by either aortic reconstruction (n = 66), crossover femorofemoral bypass (n = 38), or axillofemoral bypass (n = 6) were examined with regard to preoperative and postoperative sexual function. Aortic reconstructions were performed using a nerve-sparing technique, and special emphasis was placed on preservation or improvement of pelvic blood supply. Thirty patients (27%) were impotent preoperatively and postoperatively, 67 patients (61%) had normal sexual function preoperatively and postoperatively, and 13 patients (12%) who were impotent preoperatively regained sexual function as a result of revascularization, indicating that 30% (13/43) of all patients with preoperative impotence regained sexual function. No patient with normal preoperative sexual function was impotent postoperatively. Nerve-sparing aortic dissections, attention to preservation or improvement of pelvic blood flow, and, when appropriate, extra-anatomic bypass are essential in the preservation or improvement of sexual function after aortoiliac revascularization.

(Arch Surg 1982;117:544-550)


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