The Influence Of Percutaneous Endoscopic Lumbar Discectomy On Penile Erectile Function Of Patients With Lumbar Intervertebral Disc Herniation

ObjectiveTo explore whether the surgery can improve the penile erectile function of male patients with lumbar intervertebral disc herniation.MethodsMale patients with lumbar intervertebral disc herniation(LDH)who underwent Percutaneous Endoscopic Lumbar Discectomy from September 2014 to September 2015,were divided into young group(20 cases,20 to 39 years old),middle age group(20 cases,40 to 59 years old),elderly group(20 cases,60 years old and above).Then we surveyed the lumbar function and the sexual function using the Japanese orthopaedic association scores for assessment of myelopathy(JOA),the 5-item version of the international index of erectile function questionnaire(IIEF-5),anxiety and depression self rating scale(SAS/SDS),visual analogue scale(VAS)preoperative and postoperative 6 and 12 months.The relationship between the surgery and the male sexual function was analyzed.ResultsA total of 60 cases accomplished the follow-up.Follow-ups lasted 12~15 months,an average of(13.4±1.4)months.During the period of follow-up,the recurrent LDH of the same segment and other related complications had not happened.Compare with the preoperative level,all patients had an arisen in scores of JOA and the rate of excellent and good level's lumbar function(p<0.05).The patients in three groups all had an obvious improvement in sexual function 12 months after surgery.All three groups' patients had a lower level than preoperative in the rate of the patient with ED(p<0.05).Scores of IIEF-5 in young group improved from 15.23±1.32 to 23.43±2.07,middle age group improved from 12.55±2.24 to 20.32±3.23,elderly group improved from 11.15±2.13 to 18.41±3.19.There is significant difference of all above changes.Furthermore,The young group showed the most obvious change in sexual function.The scores of IIEF-5 and the rate of the patient with ED were not significantly different to preoperative level in the elderly group(P>0.05).Comparing with preoperative level,its scores of SDS/SAS had obvious increase(P<0.05).Through the psychological therapy,rates of patient with anxiety and depression and scores of SDS/SAS in elderly group patients were declined in 12 months after surgery compared with 6 months after surgery(P<0.05).Comparing with preoperative level,the rate of the patient with ED was decreased(P<0.05).ConclusionLDH was badly influence the penile erectile function in male patients with erectile dysfunction.Percutaneous Endoscopic Lumbar Discectomy is very important for penile erectile function recovery in male patients with LDH.Anxiety and depression had influenced the erectile function.Psychological therapy for anxiety and depression was highly recommended to help men with sexual function restored as soon as possible.