Document Detail

Complaints of micturition, defecation and sexual function in cauda equina syndrome due to lumbar disk herniation: a systematic review.
MedLine Citation:
PMID:  23238848     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Cauda equina syndrome (CES) is a rare complication of lumbar disk herniation. Although micturition, defecation and/or sexual function are by definition affected, little seems to be known about long-term outcome. Aim of this study is to review current literature on outcome of micturition, defecation and sexual function in CES due to lumbar disk herniation.
METHODS: A literature search was done in Pubmed, Embase and Web of Science using a sensitive search string combination. Studies were selected by predefined selection criteria and risk of bias was assessed using a Cochrane checklist adjusted for this purpose.
RESULTS: Fifteen studies were included. Risk of bias varied with six studies showing low risk. Mean minimal follow-up time was 17.0 months (range 3-24 months). All studies evaluated micturition and reported dysfunction at follow-up in 42.5% (range 13.3-90.0%). Defecation and sexual function were evaluated in eight and nine studies, respectively, and reported to be 49.6 (range 10.5-90.0%) and 44.3% (range 10.0-76.6%), respectively. Only two studies assessed sexual function in all patients at follow-up.
CONCLUSION: This review offers an insight into the extent of micturition dysfunction, defecation dysfunction and sexual dysfunction (SD) in CES after decompression. Our findings show that dysfunction is extremely common, even at long-term follow-up. A condition as invalidating as CES requires proper patient information and the outcomes presented here may help in providing those data. Bias in included studies, lack of universal definitions and incomplete follow-up results qualify these data as the best we momentarily have, but still subject to improvement. Since SD seems to be severely underreported, we recommend further research to explore the extent of this problem, as well as the use of questionnaires in future clinical (prospective) studies to accomplish a more patient-based approach.
N S Korse; W C H Jacobs; H W Elzevier; C L A M Vleggeert-Lankamp
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-12-13
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  22     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-20     Completed Date:  2013-12-30     Revised Date:  2014-05-08    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1019-29     Citation Subset:  IM    
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MeSH Terms
Defecation / physiology
Intervertebral Disc Displacement / complications,  physiopathology*,  surgery
Lumbar Vertebrae / physiopathology*,  surgery
Polyradiculopathy / etiology,  physiopathology*,  surgery
Rectal Diseases / etiology,  physiopathology*,  surgery
Sexual Dysfunction, Physiological / etiology,  physiopathology*
Urination / physiology
Urination Disorders / etiology,  physiopathology*,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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