Improvement of sexual function in male patients treated surgically for cervical spondylotic myelopathy

A prospective follow-up study.

To analyze the recovery of sexual function loss in surgically treated male patients with cervical spondylotic myelopathy.

Cervical spondylotic myelopathy is common in the elder population and can lead to sexual dysfunction. Although numerous studies have shown that surgical treatment of cervical spondylotic myelopathy achieved satisfactory neurologic and functional improvement, only few researchers mentioned sexual dysfunction.

A total of 22 patients with combined cervical spondylotic myelopathy and sexual dysfunction on admission were treated with surgery. The patients' preoperative and postoperative neurologic status was recorded according to the Japanese Orthopedic Association (JOA) Scoring System. The sexual function was assessed using the International Index of Erectile Function (IIEF). Special attention was also given to the preoperative and postoperative presence or absence of a reflexogenic and psychogenic erection.

In most cases, there was significant improvement in neurologic status after surgery, with a mean improvement of JOA score of 3.6. The difference between the preoperative and postoperative JOA score was significant (P < 0.05). Most of these patients had an abnormal psychogenic erection (18/22, 82%) before surgery, but only few had an abnormal reflexogenic erection (4/22, 18%). After surgery, most patients had improvement in sexual function, and the average IIEF score was 28.5 before and 60.2 after surgery. The difference between preoperative and postoperative IIEF scores was statistically significant (P < 0.05).

In addition to neurologic deficits, cervical spondylotic myelopathy also causes sexual dysfunction. Most of these patients had an abnormal psychogenic erection and normal reflexogenic erection. Along with neurologic recovery, most patients had improvement in sexual function after surgery.