Journal of Neurosurgery: Spine. 13:562-567, November 2010

Clinical article

Assessment of sexual dysfunction before and after surgery for lumbar disc herniation

Naz B. Akbaş, M.D.1, Sedat Dalbayrak, M.D.2, Duygu G. Külcü, M.D.3, Mesut Yılmaz, M.D.4, Tevfik Yılmaz, M.D.4, and Sait Naderi, M.D.5. 1Departments of Psychiatry and 3Physical Therapy and Rehabilitation, School of Medicine, Yeditepe University; 2Department of Neurosurgery and 4First Department of Neurosurgery, Kartal Research and Education Hospital; and 5Department of Neurosurgery, Umraniye Research and Education Hospital, Istanbul, Turkey. ©1944-2010 by the American Association of Neurosurgeons

Abbreviations used in this paper: HADS = Hospital Anxiety and Depression Scale; LDH = lumbar disc herniation; ODI = Oswestry Disability Index; SAQ = sexual assessment questionnaire; VAS = visual analog scale.

Object
Sexuality is an important aspect of human life. Sexual activity may be affected in lumbar disc herniation through different mechanisms. The aim of this study is to evaluate patients' sexual problems and sexual behavior patterns before and after surgical treatment of lumbar disc herniation.

Methods
Forty-three patients were included in the study (mean age 41.4 years). A visual analog scale, the Oswestry Disability Index, the Hospital Anxiety and Depression Scale, and a sexuality assessment questionnaire developed for this study were administered to the patients to evaluate pain and sexual dysfunction.

Results
Fifty-five percent of the men and 84% of the women reported experiencing sexual problems after the onset of low-back pain. The most common sexual problems were decreased sexual desire (18%) and premature ejaculation together with erectile dysfunction (18%) for the male patients, and decreased sexual desire (47%) for the female patients. The frequency of sexual intercourse before the operation was reduced in 78% of cases compared with the pain-free period. Postoperatively, the patients first attempted sexual intercourse a mean of 26.5 days after surgery. The frequency of intercourse was found to have increased (p = 0.01), while description of any type of sexual problem had decreased (p = 0.005) significantly.

Conclusions
Lumbar disc herniation has negative effects on sexual life, and not enough attention is given to the patients' sexual problems by the physicians. Decreased sexual desire and decreased sexual intercourse are the most commonly reported problems. Taking time during examination and giving simple recommendations may improve sexuality and life quality of the patients.