Moscicki Patricia, Bachmann Gloria A
Rutgers Robert Wood Johnson Medical School, Women's Health Institute, New Brunswick, NJ, USA.
Rutgers Robert Wood Johnson Medical School, Women's Health Institute, New Brunswick, NJ, USA.
Sex Med Rev. 2022 Oct;10(4):493-498. doi: 10.1016/j.sxmr.2022.01.003. Epub 2022 Jul 16.
Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal cord pathologies that require surgical interventions, there are scant data.
We undertook a narrative review to synthesize what is known on the topic, raise awareness, and call for action.
PubMed and Google Scholar identified case reports and primary studies evaluating female sexual dysfunction associated with spinal pathology as well as surgical intervention success were reviewed to contextualize and characterize female sexual dysfunction.
Available case reports and primary studies suggest that female sexual dysfunction can result from traumatic spinal etiologies, malignant tumors, and benign tumors with and without bony involvement. Although identified as a key preoperative predictor in maintenance or improvement of neurologic status, sexuality is rarely addressed in the neurosurgical care plan. In spinal stenosis and degenerative spine disease, over half of patients report pain with sexual activity. Importantly, while pain can hinder sexual activity in females, there are other sexual issues, including desire and subjective arousal, lubrication, orgasm, and satisfaction that are usually not explored. Studies show the impact of spinal pathologies on frequency of sexual intercourse, hypoesthesia, anorgasmia, and depression. Surgical intervention of spinal pathologies has been cited to improve back pain however other types of sexual dysfunction usually fails to improve after surgical intervention.
The lack of high-quality research with adequate numbers of female participants that appropriately characterizes the nuances of female sexual dysfunction across various spinal pathologies, with post-surgical intervention analysis and consideration of surgical approach, necessitates consideration for future study. A pre-op and post-op sexual history in all woman undergoing spinal surgery should be a standard of care. Moscicki P, Bachmann GA. Characterization of Female Sexual Dysfunction Associated with Spinal Pathology and Surgery. Sex Med Rev 2022;10:493-498.
研究表明性功能障碍与糖尿病和心脏病等医学状况之间存在关联。然而，在需要手术干预的脊柱和脊髓病变领域，相关数据却很少。
我们进行了一项叙述性综述，以综合该主题的已知信息，提高认识，并呼吁采取行动。
通过PubMed和谷歌学术搜索，对评估与脊柱病变相关的女性性功能障碍以及手术干预成功率的病例报告和初步研究进行了综述，以了解女性性功能障碍的情况并进行特征描述。
现有病例报告和初步研究表明，女性性功能障碍可能由创伤性脊柱病因、恶性肿瘤以及有无骨质受累的良性肿瘤引起。虽然性功能被确定为维持或改善神经功能状态的关键术前预测因素，但在神经外科护理计划中很少涉及。在腰椎管狭窄症和退变性脊柱疾病中，超过一半的患者报告有性交疼痛。重要的是，虽然疼痛会妨碍女性的性行为，但还有其他性问题，包括性欲和主观唤起、润滑、性高潮和满意度等，这些问题通常未被探讨。研究显示脊柱病变对性交频率、感觉减退、性高潮缺失和抑郁的影响。脊柱病变的手术干预已被证明可改善背痛，但其他类型的性功能障碍在手术干预后通常无法改善。
缺乏高质量研究，且女性参与者数量不足，无法恰当地描述各种脊柱病变中女性性功能障碍的细微差别，也缺乏术后干预分析和对手术方法的考虑，因此有必要进行未来研究。对所有接受脊柱手术的女性进行术前和术后性史询问应成为护理标准。莫斯西克P，巴赫曼GA。与脊柱病变和手术相关的女性性功能障碍的特征描述。性医学评论2022；10：493 - 498。
