Kamada N, Sato T, Yamada T, Aoshima M
Department of Cardiovascular Surgery, Shizuoka General Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1994 Jan;95(1):30-3.
We studied the effect of the hypogastric plexus preserving operation for Y-prosthesis replacement in abdominal aneurysm. The hypogastric plexus preserving operation was performed for avoiding postoperative sexual disorders such as the impotence and the abnormalities of ejaculation. With wide abrasion of retroperitoneum as usually, postoperative abnormalities of ejaculation occurred in 70% and postoperative impotence occurred in 50% of cases undergoing Y-prosthesis replacement. More reliable nerve preserving operation was the minimum abrasion of retroperitoneum and the aorta had not to he abrased at the origin of the inferior mesenteric artery, bifurcation of the aorta and the common iliac artery. Then with this nerve preserving operation, abnormalities of ejaculation occurred in 30% (p < 0.05) of cases and impotence occurred in 20% of cases. The results indicate that sexual dysfunction may he prevented to minimize by the nerve preserving operation.
我们研究了保留腹下神经丛手术在腹主动脉瘤Y型人工血管置换术中的效果。进行保留腹下神经丛手术是为了避免术后出现如阳痿和射精异常等性功能障碍。按照常规广泛剥离腹膜后,在接受Y型人工血管置换术的患者中,70%出现术后射精异常,50%出现术后阳痿。更可靠的神经保留手术是尽量减少腹膜后剥离,且在肠系膜下动脉起始处、主动脉分叉处和髂总动脉处不要剥离主动脉。采用这种神经保留手术后,30%(p<0.05)的患者出现射精异常,20%的患者出现阳痿。结果表明,通过神经保留手术可将性功能障碍降至最低。