Disfunción sexual tras la reparación endovascular del aneurisma de aorta abdominal infrarrenal

Summary. Introduction. Open surgery (OS) of an abdominal aortic aneurysm (AAA) is associated with deterioration in sexual function. There appears to be lower incidence of erectile dysfunction with endovascular repair (EVAR). Objectives. To analyse the incidence of post-operative sexual dysfunction in AAA patients treated using OS or EVAR. Material and methods. A prospective study carried out from January 2008 until June 2009 using the IIEF test (International Index Erectile Function) to measure pre- and post-surgical sexual dysfunction. Out of a total of 182 patients treated, 112 patients were included in the study, of which 47 (42.0%) were treated using OS and 65 (58.0%) using EVAR.Results. The mean age was 70 years (64.3 OS vs. 74.7 EVAR, P=0.032). The prevalence of pre-surgical impotence was high in both groups and was significantly higher in those treated using EVAR (40.5% OS vs. 66.2% EVAR, P=0.017). Sexual dysfunction appeared in 5 patients (22.7%) after EVAR and in 10 (35.7%) after OS (P>0.05). Both internal iliacs were occluded in 3 (13.6%) patients in the EVAR group and occluded in one artery in 10 (45%) patients. The unilateral occlusion of the hypogastric artery had no effect on impotency (P>0.05). All the bilateral occlusions suffered erectile dysfunction. The dysfunction was more severe in the EVAR group, both before and after surgery. Conclusions. The incidence of pre-operative sexual dysfunction in AAA patients is high. Treatment using EVAR does not give any significant protection against impotency occurring. The bilateral occlusion of the hypogastric arteries is a cause of sexual dysfunction, although unilateral occlusion is a significant risk factor. [ANGIOLOGÍA 2009; 61: 295-304]