title: Erectile dysfunction in young surgically treated patients with lumbar spine disease: a prospective follow-up study.
abstract: METHODS
  This is a prospective study.
  
  
  OBJECTIVE
  The prevalence of erectile dysfunction (ED) in patients younger than 50 years with fracture-unrelated lumbar spine disease requiring surgical decompression without other risk factors for ED is evaluated.
  
  
  BACKGROUND
  There is little literature documenting ED in young patients with atraumatic lumbar spine disease.
  
  
  METHODS
  All male patients younger than 50 years who underwent lumbar spine surgery during June 2006 to November 2007 without risk factors for ED were included. Patient demographics, neurological dysfunction, visual analogue scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), North American Spine Society score for neurogenic symptoms (NS), and the International Index of Erectile function (IIEF-5) scores were recorded preoperatively, at 1, 3, and 6 months.
  
  
  RESULTS
  There were 61 patients with mean age 38.4 years (SD = 7.0; range, 20-49). Most of patients had (43 or 70.5%) prolapsed intervertebral disc with discectomy being the commonest operation. Mean VAS scores, ODI, and NS improved significantly postoperatively. However, the mean IIEF-5 scores did not. Preoperatively, there was no correlation between ED and VAS scores on back pain (P = 0.70), leg pain (P = 0.91), ODI (P = 0.93), or NS (P = 0.51). At 6 months, patients with NS > 70 had an increased risk of ED (P = 0.03). Eighty percent of patients with NS > 70 had ED compared with 30% of patients with NS ≤ 70. There was, however, no correlation between ED with ODI (P = 0.38) and VAS scores on back pain (P = 0.20) or leg pain (P = 0.08) at 6 months.
  
  
  CONCLUSIONS
  The incidence of ED in patients younger than 50 years with nonfracture-related lumbar spine disease undergoing surgery without risk factors was 34.3%. Despite improvement in VAS, ODI, and NS scores postoperatively, ED did not improve. Patients with NS > 70 postoperatively were more likely to have ED reflecting possible permanent nerve damage from lumbar spine pathology.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Mashfiqul A
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: Benedict
authors.initials: B
authors.lastname: Peng
authors.forename: Nidumaran
authors.initials: N
authors.lastname: Shanmugam
authors.forename: William
authors.initials: W
authors.lastname: Yeo
authors.forename: S
authors.initials: S
authors.lastname: Fook-Chong
authors.forename: John Chen
authors.initials: JC
authors.lastname: Li Tat
authors.forename: Chang Ming
authors.initials: CM
authors.lastname: Guo
authors.forename: Seang Beng
authors.initials: SB
authors.lastname: Tan
authors.forename: Wai Mun
authors.initials: WM
authors.lastname: Yue
mesh_terms: D000328:Adult; D000367:Age Factors; D001416:Back Pain / Q000209:etiology; D016009:Chi-Square Distribution; D019299:Decompression, Surgical / Q000009:adverse effects; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007796:Laminectomy / Q000009:adverse effects; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012846:Singapore; D013122:Spinal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult