SSAT - HEMORRHOIDECTOMY AND SEXUAL FUNCTION: OUTCOMES ANALYSIS FROM A CASE-CONTROL STUDY

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HEMORRHOIDECTOMY AND SEXUAL FUNCTION: OUTCOMES ANALYSIS FROM A CASE-CONTROL STUDY
Oscar Santes^*, Oscar E. Posadas Trujillo, Paulina E. Huchim-Serv�n, Noel Salgado-Nesme
Surgery, Instituto Nacional de Ciencias M�dicas y Nutrici�n Salvador Zubir�n, Mexico, Mexico, Mexico

Background: Patients undergoing pelvic or pelvic floor surgery experience a higher prevalence of sexual problems. The impact of hemorrhoidectomy on sexual function remains understudied and is not well-recognized clinically.

Objective: To investigate the effects of hemorrhoidectomy on sexual function

Methods: Prospective case-control study, conducted at a tertiary hospital in Mexico City (July 2023 - May 2024). Adult patients with symptomatic hemorrhoids and an active sexual life were treated with either surgical (hemorrhoidectomy) or conservative medical management. The validated Natsal SF questionnaire was utilized to assess sexual function before and after intervention. The primary outcome was the development of de novo sexual dysfunction within 30 days post-intervention. Secondary outcomes included the correlation between postoperative pain and the influence of surgical technique on sexual function.

Results: This study included 40 patients, with 20 in each treatment group (hemorrhoidectomy and conservative management). Baseline demographics were comparable between groups. No significant differences were observed in age (median 65 years vs. 60 years, p=0.108) or sex distribution (65% vs. 60% male, p=0.793). Post-intervention, the frequency of sexual dysfunction was significantly higher in the hemorrhoidectomy group (85% vs. 25%, p=0.002). Among patients undergoing hemorrhoidectomy, the use of an advanced bipolar electrosurgical device (p=0.002) and lower levels of self-reported postoperative pain at 7 days (p=0.001) were significantly associated with a lower rate of sexual dysfunction.

Conclusion: Hemorrhoidectomy is associated with an increased frequency of sexual dysfunction compared to medical management. Postoperative pain appears to be a contributing factor. Patients undergoing hemorrhoidectomy should be counseled on this potential complication, and strategies for effective pain management should be optimized to minimize the impact on sexual function.

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