Sexual function after bilateral lumbar sympathectomy and aorto-iliac by-pass surgery.

Sexual function has been assessed in 44 patients under 60 years old after bilateral lumbar sympathectomy. 21 had lumbar sympathectomy alone, but in 23 it was combined with by-pass aorto-iliac surgery. Half these patients produced seminal fluid for analysis and spermatozoa were present in all. In those patients who also had aorto-iliac surgery, sexual function was impairedin 40%, ejaculation and erection difficulties occurring in the same proportion. In patients who had only bilateral sympathectomy, these complications occurred in 24% and mainly consisted of ejaculation disturbances. Only three patients became impotent, each having had aortic surgery. Serious sexual complications caused by lumbar sympathectomy alone seem relatively rare and should only preclude its use in young men wishing to reproduce.