Complaints of micturition, defecation and sexual function in cauda equina syndrome due to lumbar disk herniation: a systematic review.

By London Spine
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Complaints of micturition, defecation and sexual function in cauda equina syndrome due to lumbar disk herniation: a systematic review.

Eur Spine J. 2012 Dec 13;

Authors: Korse NS, Jacobs WC, Elzevier HW, Vleggeert-Lankamp CL

Abstract
PURPOSE: Cauda equina syndrome (CES) is a rare complication of lumbar disk herniation. Although micturition, defecation and/or sexual function are by definition affected, little seems to be known about long-term outcome. Aim of this study is to review current literature on outcome of micturition, defecation and sexual function in CES due to lumbar disk herniation. METHODS: A literature search was done in Pubmed, Embase and Web of Science using a sensitive search string combination. Studies were selected by predefined selection criteria and risk of bias was assessed using a Cochrane checklist adjusted for this purpose. RESULTS: Fifteen studies were included. Risk of bias varied with six studies showing low risk. Mean minimal follow-up time was 17.0 months (range 3-24 months). All studies evaluated micturition and reported dysfunction at follow-up in 42.5 % (range 13.3-90.0 %). Defecation and sexual function were evaluated in eight and nine studies, respectively, and reported to be 49.6 (range 10.5-90.0 %) and 44.3 % (range 10.0-76.6 %), respectively. Only two studies assessed sexual function in all patients at follow-up. CONCLUSION: This review offers an insight into the extent of micturition dysfunction, defecation dysfunction and sexual dysfunction (SD) in CES after decompression. Our findings show that dysfunction is extremely common, even at long-term follow-up. A condition as invalidating as CES requires proper patient information and the outcomes presented here may help in providing those data. Bias in included studies, lack of universal definitions and incomplete follow-up results qualify these data as the best we momentarily have, but still subject to improvement. Since SD seems to be severely underreported, we recommend further research to explore the extent of this problem, as well as the use of questionnaires in future clinical (prospective) studies to accomplish a more patient-based approach.

PMID: 23238848 [PubMed – as supplied by publisher]

Discopathy of the lumbar-sacral segment and its influence on sexual dysfunction.

By London Spine
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Discopathy of the lumbar-sacral segment and its influence on sexual dysfunction.

Adv Clin Exp Med. 2013 Jan-Feb;22(1):93-100

Authors: Dzierżanowski M, Dzierżanowski M, Wrzecion K, Słomko W, Radzimińska A, Kaźmierczak U, Strojek K, Srokowski G, Zukow W

Abstract
BACKGROUND: Intervertebral disc disease is a widespread medical and social problem. Degeneration of intervertebral discs can lead to disc disease, commonly known as discopathy. One of the consequences of discopathy is pressure on the spinal cord or nerve roots that supply the genitals and sexual centers located in the core. In addition, the accompanying pain and limitation of mobility can lead to the occurrence of sexual dysfunction.
OBJECTIVES: The goal of the study was to ascertain the influence of discopathy in the lumbosacral (L-S) segment on the occurrence of sexual dysfunction.
MATERIAL AND METHODS: The study involved 50 hospitalized patients with discopathy in the L-S segment were asked to complete a specially prepared questionnaire (11 questions). The goal of the survey was to compare the patients’ satisfaction with their sex life before and after the disease. The questions were constructed in a way that excluded other indicators that could affect their sexual activity, i.e.: bad moods, bad family relations, or a lack of sexual activity due to age or the lack of a partner.
RESULTS: Discopathy in the lumbar-sacral segment has an influence on sexual activity. A decrease in the assessment of satisfaction with one’s sex life can be observed among patients with discopathy.
CONCLUSIONS: The pain and neurological symptoms associated with intervertebral disc disease reduce the patients’ satisfaction with their sex lives. Patients in the group surveyed noted a change in sexual performance, often resulting in passivity, discouragement, weakness or a complete lack of interest in sex. The disorders also affect the emotional state. The patients also noted a significant decrease in physical activity.

PMID: 23468267 [PubMed – in process]