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The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome

Korse, Nina S ; Veldman, Anna B ; Peul, Wilco C ; Vleggeert-Lankamp, Carmen L A Sherman, Jonathan H

PloS one, 2017-04, Vol.12 (4), p.e0175987-e0175987 [Periódico revisado por pares]

United States: Public Library of Science

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The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome
Autor: Korse, Nina S ; Veldman, Anna B ; Peul, Wilco C ; Vleggeert-Lankamp, Carmen L A
Sherman, Jonathan H
Assuntos: Adult ; Aged ; Aging ; Attention ; Back surgery ; Biology and Life Sciences ; Bladder ; Care and treatment ; Cauda equina ; Cauda Equina Syndrome ; Coitus - physiology ; Compression ; Computed tomography ; Consortia ; Conversation ; Data recovery ; Death ; Decompression ; Decompression, Surgical - methods ; Defecation ; Defecation - physiology ; Developing countries ; Diagnosis ; Discomfort ; Emergencies ; Ethics ; Evaluation ; Family medical history ; Female ; Gender ; Health care ; Humans ; Informed consent ; Internet ; Intervertebral Disc Displacement - pathology ; Intervertebral Disc Displacement - physiopathology ; Intervertebral Disc Displacement - psychology ; Intervertebral Disc Displacement - surgery ; Intervertebral discs ; Intestine ; Inventories ; LDCs ; Limbs ; Lumbar Vertebrae - pathology ; Lumbar Vertebrae - physiopathology ; Lumbar Vertebrae - surgery ; Magnetic resonance ; Male ; Medical personnel ; Medical records ; Medicine and Health Sciences ; Middle Aged ; Motor task performance ; Nerves ; Neurosurgery ; Pain ; Patient outcomes ; Patients ; People and Places ; Pharmacology ; Physiological aspects ; Polls & surveys ; Polyradiculopathy - pathology ; Polyradiculopathy - physiopathology ; Polyradiculopathy - psychology ; Polyradiculopathy - surgery ; Position (location) ; Printed materials ; Prognosis ; Prospective Studies ; Quality of life ; Quality of Life - psychology ; Questionnaires ; Rectum ; Reproduction ; Resonance ; Response rates ; Sexual behavior ; Sexuality ; Social Sciences ; Spinal cord ; Spinal diseases ; Spine ; Statistical analysis ; Studies ; Surgery ; Treatment Outcome ; Urinary bladder ; Urination ; Urination - physiology
É parte de: PloS one, 2017-04, Vol.12 (4), p.e0175987-e0175987
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Conceptualization: NSK WCP CLAVL.Data curation: NSK.Formal analysis: NSK.Investigation: NSK ABV.Methodology: NSK CLAVL.Project administration: NSK CLAVL.Resources: NSK CLAVL WCP.Supervision: CLAVL WCP.Visualization: NSK.Writing – original draft: NSK.Writing – review & editing: NSK ABV WCP CLAVL.
Competing Interests: Outside the submitted work, Dr Vleggeert-Lankamp and Dr Peul report the following interests: National Health organisation sponsors a trial on treatment of cervical radiculopathy, and has been paying a trial on the treatment of spinal stenosis. Braun sponsors a study after the surgical treatment of cervical discectomies. Medtronic sponsors a study after the surgical treatment of spondylolytic listhesis. Paradigm Spine sponsors a study after the surgical treatment of spinal stenosis. These are all Investigator Initiated trials. The payment is not made to private accounts but to the research department only. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
Descrição: 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. 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. 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. 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.
Editor: United States: Public Library of Science
Idioma: Inglês

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The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome

Korse, Nina S ; Veldman, Anna B ; Peul, Wilco C ; Vleggeert-Lankamp, Carmen L A Sherman, Jonathan H

United States: Public Library of Science

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