Moradi Zahra, Shahali Shadab, Ahmadi Fazlollah, Montazeri Ali
Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares Univesity, Tehran, Iran.
Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
BMC Musculoskelet Disord. 2025 May 16;26(1):489. doi: 10.1186/s12891-025-08736-3.
Despite extensive literature on lumbar disc herniation and cauda equina syndrome, sexual dysfunction in these patients has been overlooked. We conducted a systematic review to gather scientific evidence on this issue following surgical treatment in this population.
On January 30, 2025, several databases, including PubMed, Web of Science, Scopus, and Google Scholar, were searched on the topic for English-language biomedical literature from 2014 to 2024. Two researchers assessed the quality of the articles using the Mixed Methods Appraisal Tool version 2018. The findings were narratively synthesized to effectively describe, compare, and combine the study results.
A total of 5,893 studies were identified, but after removing duplicates and irrelevant documents, only 20 studies were eligible for analysis. Of these, 90% were rated as high quality, indicating a strong level of certainty in the evidence. The analysis revealed that the prevalence of sexual dysfunction in this population ranged from 26.6% to 100%. The most common sexual disorder among women was sexual desire and arousal disorder (35% to 60%), while erectile dysfunction was the most prevalent among men (14% to 100%). Overall, dissatisfaction with sexual activities was reported by 37% to 69% of women and 69% of men. Improvements in sexual function following surgery for lumbar disc herniation were noted in 83.33% of studies (5 out of 6), compared to only 7.14% in patients with cauda equina syndrome (1 out of 14 studies).
Studies indicated a considerable enhancement in sexual function post-surgery for lumbar disc herniation patients (68% to 99%). However, long-term follow-up of cauda equina syndrome patients revealed that many continued to experience sexual issues (14% to 100%).
尽管关于腰椎间盘突出症和马尾神经综合征已有大量文献，但这些患者的性功能障碍一直被忽视。我们进行了一项系统评价，以收集该人群手术治疗后这一问题的科学证据。
2025年1月30日，在包括PubMed、科学网、Scopus和谷歌学术在内的多个数据库中，搜索了2014年至2024年期间关于该主题的英文生物医学文献。两名研究人员使用2018年混合方法评估工具评估文章质量。对研究结果进行叙述性综合，以有效描述、比较和整合研究结果。
共识别出5893项研究，但在去除重复和不相关文献后，仅有20项研究符合分析条件。其中，90%被评为高质量，表明证据的确定性程度较高。分析显示，该人群性功能障碍的患病率在26.6%至100%之间。女性中最常见的性功能障碍是性欲和性唤起障碍（35%至60%），而勃起功能障碍在男性中最为普遍（14%至100%）。总体而言，37%至69%的女性和69%的男性报告对性活动不满意。腰椎间盘突出症手术后性功能改善的研究占83.33%（6项中的5项），而马尾神经综合征患者中只有7.14%（14项研究中的1项）。
研究表明，腰椎间盘突出症患者术后性功能有显著改善（68%至99%）。然而，马尾神经综合征患者的长期随访显示，许多人仍存在性问题（14%至100%）。
