title: Two-year outcome of erectile dysfunction in patients younger than 50 years with fracture-unrelated lumbar spine disease requiring surgical decompression: a prospective study.
abstract: METHODS
  This is a prospective study.
  
  
  OBJECTIVE
  A 2-year outcome of erectile dysfunction (ED) in patients younger than 50 years with fracture-unrelated lumbar spine disease requiring surgical decompression for ED is evaluated. Risk factors for ED were also evaluated.
  
  
  BACKGROUND
  There is no literature documenting 2-year follow-up of ED status in young patients with atraumatic lumbar spine disease.
  
  
  METHODS
  All male patients younger than 50 years who underwent lumbar spine surgery between June 2006 and 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, North American Spine Society score for neurogenic symptoms, and the international index of erectile function-5 scores were recorded preoperatively and at 2 years. Patients who did not complete a 2-year follow-up were excluded. RESULTS.: A total of 75 patients were eligible for the study. Nineteen patients did not complete a 2-year follow-up giving a response rate of 75%. There were 56 patients in the study with a mean age of 38.4 (SD, 7.2; range, 20-49). The most common diagnosis was prolapsed intervertebral disc (77%) for which patients underwent discectomy. Preoperatively, 21 of 56 (37.5%) patients had ED. Despite significant improvement in mean VAS scores for back pain and leg pain, Oswestry Disability Index, and North American Spine Society score for neurogenic symptoms at 2 years (P < 0.01), the mean international index of erectile function-5 scores remained stable. Patients with ED at 2 years had greater back pain (mean VAS score 3.4) compared with patients without back pain (mean VAS score, 1.6; P ≤ 0.01).
  
  
  CONCLUSIONS
  Despite excellent outcome in most spine scores postoperatively after lumbar spine surgery, one has to be less optimistic about any improvement in the ED status of patients after surgery. ED is still a problem 2 years after surgery. Back pain reduction may have a significant role in dealing with ED at 2 years postoperatively.
  
  
  METHODS
  2.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Mashfiqul A
authors.initials: MA
authors.lastname: Siddiqui
authors.forename: Chusheng
authors.initials: C
authors.lastname: Seng
authors.forename: Nidumaran
authors.initials: N
authors.lastname: Shanmugam
authors.forename: William
authors.initials: W
authors.lastname: Yeo
authors.forename: Karen
authors.initials: K
authors.lastname: Zhang
authors.forename: Hwei Chi
authors.initials: HC
authors.lastname: 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; D001416:Back Pain / Q000209:etiology; D019299:Decompression, Surgical / Q000009:adverse effects*; D004185:Disability Evaluation; D017586:Diskectomy / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000209:etiology; D007866:Leg / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult