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血管外科医生对腹主动脉手术后射精障碍的看法:一项荷兰调查的结果

Vascular Surgeons' Views on Ejaculation Disorders After Abdominal Aortic Surgery: Results of a Dutch Survey.

作者信息

van Schaik Jan, van der Vorst Joost R, Hamming Jaap F, Elzevier Henk W, Nicolai Melianthe P J

机构信息

Department of Vascular Surgery, Leiden University Medical Centre, Leiden, the Netherlands.

Department of Vascular Surgery, Leiden University Medical Centre, Leiden, the Netherlands.

出版信息

Ann Vasc Surg. 2020 Aug;67:346-353. doi: 10.1016/j.avsg.2020.02.021. Epub 2020 Apr 1.

Abstract

BACKGROUND

The aim of this study is to evaluate vascular surgeons' knowledge and appreciation of ejaculatory dysfunction after open aortic aneurysm repair and the knowledge of possible nerve-preserving techniques.

METHODS

A Dutch national survey was conducted on sexual counseling in the case of open aortic surgery. For this purpose, a designed questionnaire based on a review of the literature in the field and on other surveys aiming to analyze care for sexual health by medical specialists was used.

RESULTS

The response rate was almost 60%. All responders were familiar with the occurrence of postoperative neurogenic complications. Sixty percent preoperatively informs their patients, but only one-third inquires whether such complications have occurred postoperatively. Most respondents estimated the incidence of postoperative neurogenic complications due to dissection of the periaortic tissues between 5% and 25%. Almost 75% take nerve anatomy into consideration when exposing the abdominal aorta, but only 29% mention the correct structures, and only 37% mention possible correct nerve-sparing techniques.

CONCLUSIONS

Dutch vascular surgeons are well aware of the occurrence of postoperative sexual disorders after infrarenal aortic reconstruction. A gap in knowledge of pathophysiology and anatomy exists. Furthermore, a significant part of vascular surgeons seems to lack skills in sexual counseling. Therefore, more education should be offered during vascular surgical training.

WHAT THIS ARTICLE ADDS

This article addresses iatrogenic neurogenic complications affecting sexual health following open aortic surgery. It opens the discussion on possible gaps in modern training of vascular surgeons and on sexual health in relation to postoperative quality of life and shared decision-making.

摘要

背景

本研究旨在评估血管外科医生对开放性主动脉瘤修复术后射精功能障碍的了解和认识,以及对可能的神经保留技术的了解。

方法

在荷兰进行了一项关于开放性主动脉手术中性咨询的全国性调查。为此,使用了一份基于该领域文献综述和其他旨在分析医学专家对性健康护理情况的调查而设计的问卷。

结果

回复率近60%。所有回复者都熟悉术后神经源性并发症的发生情况。60%的医生在术前告知患者,但只有三分之一的医生会询问术后是否发生了此类并发症。大多数受访者估计,由于腹主动脉周围组织解剖导致的术后神经源性并发症发生率在5%至25%之间。近75%的医生在暴露腹主动脉时会考虑神经解剖,但只有29%提到了正确的结构,只有37%提到了可能正确的神经保留技术。

结论

荷兰血管外科医生清楚地意识到肾下腹主动脉重建术后会出现性障碍。在病理生理学和解剖学知识方面存在差距。此外,很大一部分血管外科医生似乎缺乏性咨询技能。因此,在血管外科培训期间应提供更多教育。

本文补充内容

本文探讨了开放性主动脉手术后影响性健康的医源性神经源性并发症。它开启了关于血管外科医生现代培训中可能存在的差距以及与术后生活质量和共同决策相关的性健康问题的讨论。

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