Surgically-induced cauda equina syndrome and sexual dysfunctions in males and females

Abstract

Summary Surgically-induced cauda equina syndrome is a rare condition. The main cause is post-surgical hematoma. Cauda equina syndrome is associated, amongst other disorders, with sexual dysfunctions and with impairment of autonomous, motor and sensory functions. These disorders can be assessed both for men and women, although there are fewer studies conducted on women. The aim of this review is to take stock of the literature covering iatrogenic cauda equina syndrome. More particularly, we wish to collect existing information regarding sexual disorders and sexual function assessment methods for men and women suffering from cauda equina syndrome. Results of assessments proposed by various authors are presented. They report frequent serious and irreversible sexual dysfunctions. Cauda equina syndrome is a serious trauma both anatomically and functionally, not to mention psychologically. It therefore affects the subject in all aspects of his or her life. As such, it can only be treated by a multidisciplinary approach, combining surgical, sexological and psychological expertise. First and foremost, secondary surgical revision within the first 48 hours after onset is essential. Subsequently, there are medical treatments available to try to reduce the risk of sexual dysfunction. There must be a systematic assessment of these dysfunctions by means of sensory investigations within the perineal region. In addition, sexological and psychological treatment should be provided to support the patient in dealing with this new challenge of rebuilding a new image of themselves and a new relationship with their body within a new project for their life.