Sexual function after aorto-iliac vascular reconstruction. Which is more important, the internal iliac artery or hypogastric nerve?

Sixty patients undergoing surgical reconstruction by classical or modified methods for aorto-iliac vascular disease were studied as to postoperative sexual function. Preoperative impotence was present in approximately half of the patients with abdominal aortic occlusion. Although internal iliac arterial blood flow was regarded as an important factor in sexual function, only a slight correlation was noted between circulatory insufficiency and postoperative sexual dysfunction. Preservation of both trunks or the left trunk of the hypogastric nerve led to a marked decrease in the incidence of ejaculation disturbances. We concluded preservation of the hypogastric nerve was more beneficial than maintenance of internal iliac arterial blood flow.