The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome
| Autor: | N. S. Korse, Anna B. Veldman, Wilco C. Peul, Carmen L.A.M. Vleggeert-Lankamp |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pediatrics Medical Doctors Physiology Health Care Providers Social Sciences lcsh:Medicine Cauda equina syndrome 0302 clinical medicine Reflexes Medicine and Health Sciences Psychology Medicine Prospective Studies 030212 general & internal medicine Defecation Prospective cohort study lcsh:Science media_common Lumbar Vertebrae Multidisciplinary Coitus Obstetrics and Gynecology Middle Aged Decompression Surgical Professions Treatment Outcome Female Sensory Perception Neurosurgery medicine.symptom Intervertebral Disc Displacement Research Article Adult medicine.medical_specialty Sexual Dysfunction Urology media_common.quotation_subject Urination Surgical and Invasive Medical Procedures 03 medical and health sciences Lumbar Mental Health and Psychiatry Humans Polyradiculopathy Aged Incontinence business.industry lcsh:R Biology and Life Sciences medicine.disease Surgery Health Care Sexual dysfunction People and Places Quality of Life Women's Health Population Groupings lcsh:Q Physiological Processes Sexual function business 030217 neurology & neurosurgery Neuroscience |
| Zdroj: | PLoS ONE, 12(4) PLoS ONE, Vol 12, Iss 4, p e0175987 (2017) PLoS ONE |
| Popis: | Background Cauda equina syndrome (CES) is a rare neurologic complication of lumbar herniated disc for which emergency surgical decompression should be undertaken. Despite the common belief that the restoration of functions that are affected by CES can take several years postoperatively, follow up seldom exceeds the first year after surgery. Long term outcome of especially micturition, defecation and sexual function-which are by definition affected in CES-are unknown. The aim of this study is to evaluate 1) postoperative long term outcome of micturition, defecation and sexual function in CES patients 2) attitude of patients towards received hospital care with regard to (recovery of) these functions. Methods CES patients were selected by screening the records of all patients operated on lumbar herniated disc in our university hospital between 1995-2010. A questionnaire was sent to the selected CES patients evaluating current complaints of micturition, defecation and sexual function and attitude towards delivered care with focus on micturition, defecation and sexual function. Results Thirty-seven of 66 eligible CES patients were included (response rate 71%, inclusion rate 56%). Median time after surgery was 13.8 years (range 5.8-21.8 years). Dysfunction at follow up was highly prevalent: 38% micturition dysfunction, 43% defecation dysfunction and 54% sexual dysfunction. Younger age at presentation was associated with sexual dysfunction at follow up: for every year younger at presentation, odds ratio for sexual dysfunction at follow up was 1.11 (p = 0.035). Other associations with outcome were not identified. Two-third of the CES patients wished their neurosurgeon had given them more prognostic information about micturition, defecation and sexual function. Conclusion The presented data demonstrate that dysfunction of micturition, defecation and sexual function are still highly prevalent in a large number of CES patients even years postoperatively. These alarming follow up data probably have a devastating effect on personal perceived quality of life, which should be studied in more detail. CES patients communicate a clear demand for more prognostic information. The presented figures enable clinicians to inform their CES patients more realistically about long term postoperative outcome of micturition, defecation and sexual function after surgical intervention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|