A multicentre retrospective study of lumbar sympathectomy for plantar hyperhidrosis: satisfaction and postoperative complications

Abstract

Primary plantar hyperhidrosis has a severe impact on quality of life and conservative treatments are only effective in the short-term. Thoracic sympathectomy has proven its effectiveness in the treatment of palmar hyperhidrosis, but lumbar sympathectomy for plantar hyperhidrosis remains poorly described. The objective of this study is to report the satisfaction of treated patients as well as the postoperative complications. This was a multicenter retrospective observational study of sixteen patients with primary plantar hyperhidrosis, treated with mechanical lumbar sympathectomy from December 2012 to October 2022. Patients’ characteristics were collected from medical records. Quality of life, postoperative satisfaction and complications were evaluated using a standardized questionnaire. Lumbar sympathectomy was performed on 16 patients, fourteen were women and two were men with a total of thirty-one procedures. 87.5% of patients were satisfied and would recommend the surgery to other patients. Compensatory hyperhidrosis occured in 75% of patients, recurrence of hyperhidrosis in 31.3% and sexual dysfunction in 18.8%. Lumbar sympathectomy provides satisfying results for plantar hyperhidrosis with acceptable postoperative complications, regardless of gender. Compensatory hyperhidrosis was the most frequent complication but had no impact on patient satisfaction. Data on the risk of sexual dysfunction are reassuring, with only one case of transient ejaculation disorder.