Sexual Dysfunction after Elective Endovascular or Hand-Assisted Laparoscopic Abdominal Aneurysm Repair

Abstract

Objective To evaluate the incidence of sexual dysfunction and retrograde ejaculation after elective endovascular aneurysm repair (EVAR) and hand-assisted laparoscopic surgery (HALS) for abdominal aortic aneurysm (AAA). Methods A total of 100 patients eligible for elective repair of infrarenal AAAs were randomised in two groups: EVAR and HALS. The quality of sexual function was evaluated using the International Index of Erectile Function (IIEF), a 15-item questionnaire. Patients completed the IIEF preoperatively and at 12 months. The incidence of retrograde ejaculation was also evaluated. Results One- and 12-month mortality rates were zero. Three patients in the EVAR group (6%) and two patients in the HALS group (4%) reported an erectile dysfunction ( p = NS). The quality of sexual function at 1 year was similar in both groups: total score of 66 in the EVAR group versus 68 in the HALS group ( p = 0.66). Retrograde ejaculation was detected in three cases in the HALS group versus no case in the EVAR group. Conclusions The HALS technique could be a minimally invasive alternative for sexually active males unsuitable for EVAR repair.