[Effect of surgery for combined abdominal aortic and internal iliac artery aneurysm on postoperative intestinal ischemia and sexual dysfunction].

The effect of surgery for combined abdominal aortic aneurysm (AAA) and internal iliac artery aneurysm (IIAA) on postoperative intestinal ischemia and sexual dysfunction was studied. Nineteen men and three women, aged 51 to 79 years, were included in this study. The IIAA was unilateral in 13 cases and bilateral in 9. The maximum diameter of the IIAAs ranged from 3.0 to 7.5 cm. Seven cases underwent emergent surgery for aneurysmal rupture. A bifurcated graft was implanted in all cases. Among cases with unilateral IIAA, aneurysmectomy and IIA reconstruction was performed in 2 cases, and ligation of the IIA was performed in the remaining 11. Among cases with bilateral IIAAs, IIA reconstruction was performed on one side and IIA ligation on the another side in 1 case. Bilateral ligation was performed in 4 and exclusion of the AAA and both IIAAs were performed in 4. The inferior mesenteric artery was reconstructed in 10 cases. The average postoperative follow-up period was 6.2 years. Postoperatively 2 cases experienced bowel necrosis and 4 had diarrhea and/or mucous stool. An erectile disturbance occurred postoperatively in 33.3% of cases which had undergone unilateral and 50% of cases which had undergone bilateral IIA ligation.