Loureiro Marcelo de Paula, Novais Pietro Maran, Coelho Ruimário Machado, Paulin João Augusto Nocera
Universidade Positivo - UP, Curitiba, PR, Brasil.
Universidade Federal do Paraná - UFPR, Hospital de Clínicas - HC, Curitiba, PR, Brasil.
J Vasc Bras. 2024 Sep 27;23:e20240014. doi: 10.1590/1677-5449.202400142. eCollection 2024.
Plantar hyperhidrosis (PHH) is a disease with high psychosocial impact, and endoscopic lumbar sympathectomy (ELS) has been shown to be the best choice for treatment, but with some concerns such as compensatory sweating (CS) and sexual effects (SE), particularly in men.
The aim of this study is to evaluate the long-term effectiveness of ELS for controlling PHH in men, its side effects, and perceived sexual modifications.
A cross-sectional study including only male patients operated for PHH with ELS between 2014-2022 at a private practice. During remote interviews, patients were asked about symptoms before and after ELS and about the postoperative effects on PHH. They were also objectively asked about any SE during the postoperative period. Validated quality of life for hyperhidrosis and erectile function questionnaires were also administered.
10 male patients averaging 4.26±2.86 years post-ELS were interviewed. Eight of them (80%) achieved complete response (≥80% of sweat reduction) in the first month after surgery and this response was maintained up to the interview date. Two patients had partial response. In six patients, CS occurred, with 5 reporting it as non-troublesome. Six patients reported some type of SE, but none reported erectile dysfunction. Regarding the functional results, all patients rated ELS from good (10%) to very good (30%) or excellent (60%).
Endoscopic lumbar sympathectomy was effective for treatment of plantar hyperhidrosis in these patients, improving their quality of life and providing lasting PHH control, with some transient sexual dysfunctions that did not impair their sexual life.
足底多汗症（PHH）是一种对心理社会有高度影响的疾病，内镜下腰交感神经切除术（ELS）已被证明是最佳治疗选择，但存在一些问题，如代偿性出汗（CS）和性功能影响（SE），尤其是在男性中。
本研究旨在评估ELS治疗男性PHH的长期疗效、副作用以及感知到的性功能改变。
一项横断面研究，仅纳入2014年至2022年期间在一家私人诊所接受ELS治疗PHH的男性患者。在远程访谈中，询问患者ELS前后的症状以及术后对PHH的影响。还客观询问了术后期间的任何SE情况。同时发放了经过验证的多汗症生活质量问卷和勃起功能问卷。
对10名平均在ELS术后4.26±2.86年的男性患者进行了访谈。其中8人（80%）在术后第一个月实现了完全缓解（出汗减少≥80%），且这种缓解一直持续到访谈时。2名患者有部分缓解。6名患者出现了CS，其中5人表示不困扰。6名患者报告了某种类型的SE，但均未报告勃起功能障碍。关于功能结果，所有患者对ELS的评价从良好（10%）到非常好（30%）或优秀（60%）。
内镜下腰交感神经切除术对这些患者治疗足底多汗症有效，改善了他们的生活质量并提供了持久的PHH控制，伴有一些短暂的性功能障碍，但并未损害他们的性生活。
