Günerhan Göksal, Aykanat Can, Uçkun Ozhan Merzuk, Aslan Yılmaz, Divanlıoğlu Denizhan, Işıtan Egemen, Tunç Bekir, Tuncel Altuğ, Belen Ahmet Deniz, Dalgıç Ali
Department of Neurosurgery, University of Health Science, Ankara City Hospital, Ankara, Turkey.
Department of Urology, University of Health Science, Ankara City Hospital, Ankara, Turkey.
J Neurol Surg A Cent Eur Neurosurg. 2024 Jan;85(1):26-31. doi: 10.1055/s-0042-1759824. Epub 2023 Jun 1.
Neuroregulation of sexual functions requires coordination of parasympathetic, sympathetic, and somatosensory neuronal pathways. The nerves formed by the lower lumbar plexus provide the innervation of the urogenital organs. Lower lumbar disc hernias (LDHs) might impair the neuroregulation of sexual functions by compressing the neural structures. This prospective study aims to evaluate the effect of lower LDHs on libido and sexual dysfunctions.
A total of 61 sexually active patients diagnosed with single-level LDH who underwent unilateral microdiscectomy were included in the study. The patients' healthy sex partners were included in study as controls. The International Sexual Function Index-5 (IIEF-5) and Female Sexual Function Index (FSFI) were used for sexual assessment of male and female participants, respectively. Visual Analog Scale (VAS) was used for pain assessment.
According to the FSFI scores, all 20 female patients had preoperative sexual dysfunction, which improved in 15 (75%) patients after surgery ( < 0.001). According to the IIEF-5 score for men, 38 of 41 male patients had preoperative sexual dysfunction, which improved in 26 (68.4%) patients postoperatively ( < 0.001).
The preoperative sexual dysfunctions of LDH patients improved significantly after the microdiscectomy.
性功能的神经调节需要副交感神经、交感神经和躯体感觉神经元通路的协调。由下腰椎丛形成的神经为泌尿生殖器官提供神经支配。下腰椎间盘突出症（LDH）可能通过压迫神经结构来损害性功能的神经调节。本前瞻性研究旨在评估下腰椎间盘突出症对性欲和性功能障碍的影响。
共纳入 61 例经单侧微创手术治疗的单节段 LDH 患者。将患者健康的性伴侣纳入研究作为对照组。使用国际勃起功能指数-5（IIEF-5）和女性性功能指数（FSFI）分别评估男性和女性参与者的性功能。使用视觉模拟量表（VAS）评估疼痛。
根据 FSFI 评分，20 名女性患者术前均有性功能障碍，术后 15 名（75%）患者得到改善（ < 0.001）。根据 IIEF-5 评分，41 名男性患者术前均有性功能障碍，术后 26 名（68.4%）患者得到改善（ < 0.001）。
LDH 患者经微创手术治疗后，术前性功能障碍明显改善。
