Pre and Postoperative Sexual Dysfunction in Patients with Leriche Syndrome-A Prospective Pilot Study.

Michał Tkocz,Anna Brzęk,Mateusz Marcinek,Damian Ziaja,Violetta Skrzypulec-Plinta

doi:10.3390/ijerph19053091

Abstract

Background: Recovery of normal arterial inflow in the lower limbs after Leriche’s syndrome surgery does not always improve erection. This study assesses the effects of Leriche syndrome on erectile and ejaculatory dysfunction in patients awaiting surgical treatment and the impact of treatment used on sexual dysfunctions. Methods: 35 men with Leriche syndrome aged 61.3 years (SD = 7.74) were assessed for erectile dysfunction. The patients were classified into three groups: aortofemoral bypass (group 1); stenting of the iliac artery (group 2) and aortobifemoral bypass (group 3). The patients were qualified for surgery based on the TASC II guidelines. Follow-up was done 3 months after treatment. Results: The mean preoperative IIEF-5 score was 14. 69 (+/− 5.30), with better preoperative scores obtained by 54.3% of patients. A total of 51.4% and 48.6% of patients, respectively, reported normal erection enabling satisfactory penetration and normal ejaculation before treatment. After surgical treatment, satisfactory erection was reported by 60% of all surgically treated patients, whereas the presence of ejaculation was reported by only 14.2% of patients. Conclusions: The IIEF-5 score is a tool for careful assessment of vascular erectile dysfunctions, it allows for the evaluation of erectile dysfunctions in relation to atherosclerosis risk factors. The treatment strategy used allowed for slight improvement as evidenced to erection but decreasing normal ejaculation.

Highlights

These slowly progressing changes lead to lower limb ischaemia, and cause vascular erectile disorders of varying severity [1]
We focused on erectile dysfunction occurring before and after surgery for Leriche syndrome in terms of internal iliac artery obstruction, and what effect revascularization had on sexual dysfunction
Considering the same risk factors leading to Leriche syndrome and a history of erectile dysfunction, a relationship between intermittent claudication and the lack of erection, which was reported by 54.2%

Summary

Introduction

Aortoiliac (aortobifemoral) occlusive disease ( known as Leriche syndrome) is a condition that takes many years to develop, gradually leading to symptoms resulting from impaired perfusion of tissues supplied by the final segment of the abdominal aorta and iliac arteries. These slowly progressing changes lead to lower limb ischaemia, and cause vascular erectile disorders of varying severity [1]. Surgical revascularization may cause insufficient arterial inflow to the lesser pelvis and despite restoring adequate blood supply to the lower limbs, it causes erectile disorders of varying severity.

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