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Eur J Vasc Endovasc Surg. 2010 Jul;40(1):71-5. doi: 10.1016/j.ejvs.2010.03.007. Epub 2010 Apr 18.

Sexual dysfunction after elective endovascular or hand-assisted laparoscopic abdominal aneurysm repair.

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Department of Surgery, Transplantation and Advanced Technologies, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Via Santa Sofia, 86, 96123 Catania, Italy.



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).


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.


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.


The HALS technique could be a minimally invasive alternative for sexually active males unsuitable for EVAR repair.

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