Sexual and Bladder Dysfunction in Cauda Equina Syndrome: Correlation with Clinical and Urodynamic Studies

Area of Science:

• Neurology
• Urology
• Sexual Medicine

Background:

• Cauda equina syndrome (CES) literature often overlooks sexual dysfunction (SD).
• Prevalence and recovery of SD in CES patients require further investigation.
• Understanding SD and bladder dysfunction in CES from lumbar disc herniation is crucial due to the affected age group.

Purpose of the Study:

• To analyze clinical and sphincteric outcomes in cauda equina syndrome (CES) patients.
• To determine the extent of sexual dysfunction (SD) in CES.
• To assess correlations between SD and patient-reported/clinical/urodynamic parameters.

Main Methods:

• Retrospective cohort study of CES patients due to lumbar disc herniation.
• Collected clinical data, operative variables, and recovery information.
• Utilized cystometry, uroflowmetry, and validated questionnaires (IIEF, FSFI) to assess SD.

Main Results:

• Urodynamic studies correlated significantly with age, bladder involvement duration, perianal numbness, and motor weakness.
• Perianal sensation and motor weakness determined bladder function.
• SD showed significant correlation with age and pre-operative bladder involvement duration.

Conclusions:

• Surgical timing impacts functional and sexual outcomes in CES.
• Unilateral leg pain and hypocontractile bladder are associated with better patient outcomes.
• Sexual dysfunction represents a considerable challenge for CES patients.