Delayed Ejaculation After Lumbar Spine Surgery: A Claims Database Analysis

Bhambhvani, Hriday P.; Kasman, Alex M.; Zhang, Chiyuan A.; Hu, Serena S.

doi:10.1177/2192568220962435

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…Critical components of the history intake include medical, surgical, psychiatric, sexual, social, and religious history. Medical history should include conditions associated with neuropathy, metabolic derangements, or trauma; surgical history should include the history of neurologic and pelvic procedures [ 49 ]. To date, no studies have identified an association between orgasmic dysfunction and recreational drug use, pornography use, or painful intercourse, but these still represent important components of the social history.…”

Section: Patient Evaluation and Diagnosis Of Domentioning

confidence: 99%

Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers

et al. 2023

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Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. Given the multifactorial complex nature of this disorder, a thorough history and physical examination represent the most critical components of patient evaluation in the clinical setting. Treating DO/AO can be challenging due to the lack of standardized FDA-approved pharmacotherapies. There is no standardized treatment plan for DO/AO, though common treatments plans are often multidisciplinary and may include adjustment of offending medications and sex therapy. In this review, we summarize the etiology, diagnosis, and treatment of DO/AO.

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Section: Patient Evaluation and Diagnosis Of Domentioning

confidence: 99%

Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers

et al. 2023

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“…Ejaculatory disorders (ED) are a commonly cited complication occurring in lumbar spinal surgeries, thought to occur primarily due to hypogastric plexus injury during access to the surgical corridor [40]. Factors associated with an increased risk of ED are obesity [8] and use of BMP. Neuroinflammation is a side effect of BMP investigated by the Food and Drug Administration (FDA), with indications that its use near the hypogastric plexus could result in complications arising from compound leakage.…”

Section: Rates Of Rementioning

confidence: 99%

Is there a variance in complication types associated with ALIF approaches? A systematic review

Feeley

Clesham

et al. 2021

Acta Neurochir

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Purpose Anterior lumbar interbody fusion (ALIF) is a well-established alternative to posterior-based interbody fusion techniques, with approach variations, such as retroperitoneal, transperitoneal, open, and laparoscopic well described. Variable rates of complications for each approach have been enumerated in the literature. The purpose of this study was to elucidate the comparative rates of complications across approach type. Methods A systematic review of search databases PubMed, Google Scholar, and OVID Medline was made to identify studies related to complication-associated ALIF. PRISMA guidelines were utilised for this review. Meta-analysis was used to compare intraoperative and postoperative complications with ALIF for each approach. Results A total of 4575 studies were identified, with 5728 patients across 31 studies included for review following application of inclusion and exclusion criteria. Meta-analysis demonstrated the transperitoneal approach resulted in higher rates of retrograde ejaculation (RE) (p < 0.001; CI = 0.05–0.21) and overall rates of complications (p = 0.05; CI = 0.00–0.23). Rates of RE were higher at the L5/S1 intervertebral level. Rates of vessel injury were not significantly higher in either approach method (p = 0.89; CI = − 0.04–0.07). Rates of visceral injury did not appear to be related to approach method. Laparoscopic approaches resulted in shorter inpatient stays (p = 0.01). Conclusion Despite the transperitoneal approach being comparatively underpowered, its use appears to result in a significantly higher rate of intraoperative and postoperative complications, although confounders including use of bone morphogenetic protein (BMP) and spinal level should be considered. Laparoscopic approaches resulted in shorter hospital stays; however, its steep learning curve and longer operative time have deterred surgeons from its widespread adaptation.

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“…Disorders of ejaculation may be a manifestation of sexual dysfunction in male patients following spine surgery. In a recent large retrospective review, authors found an overall incidence of 0.09% of delayed ejaculation following spine surgery, with ALIF portending the highest risk of delayed ejaculation at a rate of 0.13% [18]. Older male patients are at higher risk of retrograde ejaculation, while in younger male patients, such as those undergoing scoliosis deformity correction, damage to these sympathetic nerves may cause priapism due to unopposed parasympathetic activation [2,19].…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

“…Although pharmacologic interventions exist for the treatment of retrograde ejaculation, anejaculation is more difficult to manage and represents a more serious complication of sympathetic neuronal disruption. While rare, these complications can be considerably distressing to patients and should be identified during routine patient visits postoperatively [18].…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

Genitourinary complications in orthopaedic surgery

Testa

Alam

Kahan

et al. 2021

Eur J Orthop Surg Traumatol

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Genitourinary complications following orthopaedic intervention are uncommon but well-described occurrences and exist on a spectrum of severity. These complications vary depending on the anatomic location and surgical approach, with surgery of the spine, hip, and pelvis of particular concern. Injuries to the urinary tract may present acutely with urinary retention or hematuria. However, they often have a delayed presentation with severe complications such as urinary fistula and recurrent infection. Delayed presentations may place the onus of timely and proper diagnosis on the orthopaedic provider, who may serve as the patient's primary source of long-term follow-up. Detailed knowledge of anatomy and at-risk structures is key to both preventing and identifying injury. Although iatrogenic injury is not always avoidable, early identification can help to facilitate timely evaluation and management to prevent long-term complications such as bladder dysfunction, obstructive renal injury, sexual dysfunction, and chronic pain.

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Delayed Ejaculation After Lumbar Spine Surgery: A Claims Database Analysis

Cited by 5 publications

References 41 publications

Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers

Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers

Is there a variance in complication types associated with ALIF approaches? A systematic review

Genitourinary complications in orthopaedic surgery

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