J.Jpn. Surg. Soc.. 85(11): 1433-1439, 1984

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Original article

SEVERAL FACTORS INFLUENCING MALE SEXUAL FUNCTION IN PATIENTS WITH ATHEROSCLEROTIC DISEASE

Patients with arteriosclerosis obliterans (ASO, n = 58), abdominal aorttic aneurysm (AAA, n = 27) and the combined disease (n=4) were objected to this study. All patients were evaluated by retrograde aortography and questioned personally as to their present male sexual function. The penile and ankle systolic pressure index (PSPI and ASPI) of patients with ASO were measured using a Doppler device, but in the patients with AAA, only the PSPI was taken.
Several factors relating to male sexual function, such as, age, PSPI, ASPI, sites of the arterial occlusion or dilatation, classification of the ischemic symptoms according to Fontaine's category, numbers of pulsations of the femoral artery, were statistically analysed.
All of the patients with both diseases, 66 percent of those with ASO and 52 percent of those with AAA were impotent. In the patients with AAA, the PSPI of the potent group was not significantly higher than that of the impotent group ; however, in patients with ASO, the PSPI of the former group was significantly higher than that of the latter group.
In the patients with ASO, a significant correlation between the PSPI and the ASPI (r=0.49, p＜0.01) was found. When a PSPI value (PSPI = 0,70) was chosen as a demarcation between the impotent group and the potent group, 84 percent of the patients with ASO were correctly classified. However, when the ASPI (ASPI = 0.45) was used, only 69 percent were properly classified. The PSPI and ASPI of the patients with an occlusion proximal to the external iliac artery were significantly less than those of the patients with an occlusion distal to the common iliac artery, and the frequency of impotence of the former group was significantly greater than that of the latter group (p＜0.025).
There were significant differences in the PSPI and the frequency of impotence between the patients with ASO under 60 years old and those over 60 years old.
In the patients with ASO, 3 patients were potent in spite of having no bilateral femoral arterial pulse and in these patients, the bilateral external iliac arteries were usually occulded, but the aorta and the common iliac artery were usually patent.
From these results, measurement of the penile blood pressure appeared to be an useful adjunct in the evaluation of the impotent men with athelosclerotic diseases, especially in patients with ASO.

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