Roth Tabea Annina, Rachamin Yael, Aghayev Emin, Albertazzi Elena, Kouba Lukas, Diel Peter, Teuscher Regula, Benneker Lorin Michael, Heini Paul Ferdinand
Research Centre, Lindenhofgruppe AG, Bern, Switzerland.
Medizinische Fakultät Universität Bern, Bern, Switzerland.
Int J Spine Surg. 2025 Jun 12;19(3):316-323. doi: 10.14444/8768.
Anterior lumbar interbody fusion (ALIF) surgery can damage nerve fibers and has been linked to retrograde ejaculation in men. In women, sexual dysfunction following ALIF is rarely investigated. The aim of this study was to investigate the frequency of postoperative changes in sexual function and incontinence in women following ALIF.
For this study, 173 female patients aged 18 to 60 years who had undergone a primary ALIF surgery in 2015 to 2022 in a large spine center to retrospectively answer a questionnaire about sexual function and incontinence pre- and postoperatively; they were also asked to rate their satisfaction with the surgery. McNemar tests were used to compare the prevalence of specific problems pre- vs postoperatively.
Of all respondents ( = 84), 23 (27%) reported a worsening of sexual function following ALIF surgery, and these changes were persistent in 83% of those patients. Among individual symptoms of sexual dysfunction, the highest increase was observed for the prevalence of vaginal dryness, which increased from 12% preoperatively to 32% postoperatively ( < 0.001), followed by dyspareunia, which increased from 8% to 21% ( = 0.001). Urinary incontinence increased from 25% to 41% ( < 0.001). Patient age, level of surgery, and fusion material were not associated with worsening of sexual function. However, worsening of sexual function was associated with a lower level of satisfaction with the surgery outcome and a lower proportion of patients who would have the surgery again.
Female patients undergoing ALIF should receive adequate preoperative information about potential changes in sexual function to enable them to make an informed decision.
An improved understanding among patients will lead to more realistic patient expectations and higher patient satisfaction.
腰椎前路椎间融合术（ALIF）手术可能会损伤神经纤维，并且与男性逆行射精有关。在女性中，很少有人研究ALIF术后的性功能障碍。本研究的目的是调查女性患者ALIF术后性功能改变和尿失禁的发生率。
在本研究中，对2015年至2022年期间在一家大型脊柱中心接受初次ALIF手术的173名年龄在18至60岁之间的女性患者进行回顾性研究，让她们回答一份关于术前和术后性功能及尿失禁情况的问卷；还询问了她们对手术的满意度。采用McNemar检验比较术前和术后特定问题的发生率。
在所有受访者（n = 84）中，23人（27%）报告ALIF手术后性功能恶化，其中83%的患者这些变化持续存在。在性功能障碍的各个症状中，阴道干涩的发生率增加最为明显，从术前的12%增至术后的32%（P < 0.001），其次是性交困难，从8%增至21%（P = 0.001）。尿失禁从25%增至41%（P < 0.001）。患者年龄、手术节段和融合材料与性功能恶化无关。然而，性功能恶化与对手术结果的满意度较低以及愿意再次接受手术的患者比例较低有关。
接受ALIF手术的女性患者应在术前获得关于性功能潜在变化的充分信息，以便她们能够做出明智的决定。
患者之间更好的理解将导致更现实的患者期望和更高的患者满意度。
