Patients experience improvement in pain during sexual activity at one year following LSS surgery, new study finds

Siril Holmberg

A large proportion of patients undergoing surgery for lumbar spinal stenosis (LSS) experienced an improvement in pain during sexual activity at one year, according to the results of a recent study published in the journal Spine.

The multicentre observational study authored by Siril Holmberg (Norwegian University of Science and Technology, Trondheim, Norway) et al, was designed to evaluate changes in pain during sexual activity after surgery for LSS, and because, according to the study authors there are “limited data available” on sexual function in patients undergoing this type of surgery.

Data from the Norwegian Registry for Spine Surgery was used and the primary outcome was change in pain during sexual activity at one year, assessed by item number eight of the Oswestry Disability Index (ODI) questionnaire. Secondary outcome measures included ODI, EuroQol-5D, and numeric rating scale scores for back and leg pain.

A total of 12,954 patients were included, 9,908 (76.5%) of which completed one-year follow-up. At baseline 9,579 patients (73.9%) provided information about pain during sexual activity, whereas 7,424 (74.9%) among those with complete follow-up completed this item.

Preoperatively 2,528 of 9,579 patients (26.4%) reported a normal sex-life without pain compared with 4,294 of 7,424 patients (57.8%) at one year. Preoperatively 1,007 (10.5%) patients reported that pain prevented any sex-life, compared with 393 patients (5.3%) at one year. At baseline 7,051 of 9,579 patients (73.6%) reported that sexual activity caused pain, and among these 3,145 of 4,768 responders (66%) reported an improvement at one year.

In addition, a multivariable regression analysis showed that having a life partner, college education, and working until time of surgery were predictors of improvement in pain during sexual activity. Current tobacco smoking, pain duration >12 months, previous spine surgery, and complications occurring within three months were negative predictors.

Speaking to Spinal News International, Holmberg said: “This study demonstrates that a large proportion of patients undergoing surgery for LSS experienced an improvement in sexual activity. Despite its fundamental role in human life, sexual dysfunction in spinal patients and counseling about sexual health is not often done in neurosurgical care.

“The results in this study might help increase the focus on the subject and make both patients and surgeons aware that sexual dysfunction is something that is strongly associated to quality of life. Furthermore, the mean age of this study population was 66 years (± 10.5), which demonstrates that regardless of age, ‘bringing sexy back’ should be of importance when consulting patients before spinal surgery.”


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