title: Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness.
abstract: BACKGROUND
  Little seems to be known about the sexual dysfunction (SD) in lumbar intervertebral disc herniation.
  
  
  OBJECTIVE
  Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions.
  
  
  METHODS
  A retrospective analysis.
  
  
  METHODS
  Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014.
  
  
  METHODS
  Statistical analysis was performed using the Predictive Analytics SoftWare (PASW) Statistics 18.0 for Windows (Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois). The statistical significance was set at P < 0.05. The Wilcoxon signed ranks test was used to evaluate the difference between patients.
  
  
  RESULTS
  Four patients with sexual and sphincter dysfunction were found, including two women and two men, aged between 20 and 52 years. All of them admitted without low back pain. In addition, on neurological examination, reflex and motor deficit were not found. However, almost all patients had perianal sensory deficit and sexual and sphincter dysfunction. Magnetic resonance imaging (MRI) of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. In fourth patient, there were not prominent disc herniations. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease.
  
  
  CONCLUSIONS
  A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. The improvement of perianal sensory deficit after surgery was counteracted by a trend toward disturbed sexual function. Further researches are needed to explore the extent of this problem.
authors.affiliation: Department of Urology, Faculty of Medical, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Nezih
authors.initials: N
authors.lastname: Akca
authors.affiliation: Department of Neurosurgery, Faculty of Medical, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozdemir
authors.affiliation: Department of Neurosurgery, Faculty of Medical, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Kanat
authors.affiliation: Department of Neurosurgery, Faculty of Medical, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Osman Ersagun
authors.initials: OE
authors.lastname: Batcik
authors.affiliation: Department of Neurosurgery, Karadeniz Technical University, Faculty of Medical, Trabzon, Turkey.
authors.forename: Ugur
authors.initials: U
authors.lastname: Yazar
authors.affiliation: Department of Urology, Faculty of Medical, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Orhan Unal
authors.initials: OU
authors.lastname: Zorba
keywords: Sphincter dysfunction; lumbar disc herniation; sexual dysfunction