STUDY DESIGN: This is a prospective study.
OBJECTIVE: A 2-year outcome of erectile dysfunction (ED) in patients under 50 years with fracture-unrelated lumbar spine disease requiring surgical decompression for ED is evaluated. Risk factors for ED were also evaluated.
SUMMARY OF BACKGROUND DATA: There is no literature documenting 2 year follow up of ED status in young patients with atraumatic lumbar spine disease.
METHODS: All male patients under 50 years who underwent lumbar spine surgery during June 2006-November 2007 without risk factors for ED were included. Patient demographics, neurological dysfunction, Visual Analogue Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), North American Spine Society score for neurogenic symptoms (NSS) and the International Index of Erectile function (IIEF-5) scores were recorded pre-operatively and at 2 years. Patients who did not complete a 2-year follow-up were excluded.
RESULTS: There were 75 patients eligible for the study. 19 patients did not complete a 2-year follow-up giving a response rate of 75%. There were 56 patients in the study with a mean age of 38.4 (SD 7.2, Range 20-49). The most common diagnosis was prolapsed intervertebral disc (77%) for which patients underwent discectomy. Pre-operatively, 21 of 56 (37.5%) patients had erectile dysfunction. Despite significant improvement in mean VAS scores for back pain, leg pain, ODI and NSS at 2 years (p < 0.01), the mean IIEF-5 remained stable. Patients with ED at 2 years had greater back pain (mean VAS score 3.4) compared to patients without back pain (mean VAS score 1.6, p≤ 0.01).
CONCLUSION: Despite excellent outcome in most spine scores post-operatively after lumbar spine surgery, one has to be less optimistic about any improvement in the ED status of patients after surgery. Erectile dysfunction is still a problem 2 years post-surgery. Back pain reduction may have a significant role in dealing with ED at 2 years post-operatively.
Written by:
Siddiqui MA, Seng C, Shanmugam N, Yeo W, Zhang K, Chi Chong H, Chen Li Tat J, Ming Guo C, Tan SB, Yue WM. Are you the author?
Department of Orthopaedic Surgery, Singapore General Hospital 2Orthopaedic Diagnostic Centre, Singapore General Hospital.
Reference: Spine (Phila Pa 1976). 2012 Dec 4. Epub ahead of print.
doi: 10.1097/BRS.0b013e318280923d
PubMed Abstract
PMID: 23222569
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