It may result from direct mechanical compression of Cauda equina CE nerve roots. Post-operative course and follow-up The longest follow-up was 2 years and the shortest was 6 months. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. He had retention of urine with a distended bladder. The patients admitted with a few days history of numbness in her buttocks, urinary, and fecal incontinence. Following surgery, three patients stated that they were less active and passive and one lost interest in sex. On neurological examination, knee and ankle flexion and Achilles reflexes were normal. His sensation was gradually improved. An urgent, hemipartial laminectomy of left side L5 was performed and a massive disc prolapse, compressing the CE, was removed.
In three patients, a large extruded disc fragment was seen on the left side. He had retention of urine with a distended bladder. However, sexual function and tendon reflexes had not returned to normal even 2 years after the operation. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. The herniation was at the disc between L5 and S1 vertebrae in all patients. Magnetic resonance imaging MRI of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. His sensation was gradually improved. In this study, a syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. The patients admitted with a few days history of numbness in her buttocks, urinary, and fecal incontinence. Perianal sensation was scored as 0: Neurological examination of the trunk and lower limbs was undertaken. On examination, there was absence of ankle reflexes and hypoaesthesia in the L5, S1 dermatomes on the left side and neurogenic claudication. For decades, lumbar discectomy has been one of the most common surgical practices performed by neurosurgeons. MRIs confirm the diagnosis and reveal the exact level of disk herniation. Pre-operative period, there was no motor deficit. The bladder control returned by the eight week after operation and although he was able to pass urine on his own, it took 4 months to recover normal bladder function. It may result from direct mechanical compression of Cauda equina CE nerve roots. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease. Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September March In fourth patient, prominent disc herniation was not observed. Only in one patient, sexual function slightly improved. A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. Almost all patients had a clear perianal sensory deficit, diminished anal tone, and sexual dysfunction, and they did not have any limitation of straight leg- raising. The Wilcoxon signed ranks test was used to evaluate the difference between patients. Magnetic resonance imaging MRI scans were obtained in all patients.
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