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Young women with AIS encounter sexual problems after corrective surgery
Patients studied had higher Female Sexual Distress Scale scores in several areas after fusion surgery for adolescent idiopathic scoliosis.
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Patients who underwent fusion for adolescent idiopathic scoliosis showed decreased sexual function many years after surgery, according to a presenter from Israel.
“The female patients who underwent correction for adolescent idiopathic scoliosis (AIS) have high Female Sexual Distress Scale scores with a decreased sexual arousal, orgasm and satisfaction,” Josh E. Schroeder, MD, of Hadassah Hebrew University Medical Center in Jerusalem, said. “We are not sure if it is due to the surgery or the pathology,” he said at a recent meeting.
The project was conducted by Leon Kaplan, MD, director of the spine unit at Hadassah Medical Center.
Lack of evidence
Sexual dysfunction is prevalent in 43% of women, mainly of older age, 31% of men and 50% of couples, Schroeder said. There is only one study looking at sexual dysfunction in women after surgery for AIS. A study by Danielsson and Nachemson found no sexual dysfunction among women with AIS at the 22-year follow-up.
However, that study, from 2001, is no longer relevant, according to Schroeder.
“It is 22 years of follow-up. That means surgery was done in the 1970s, about 30 years ago — different surgical techniques, no validated questionnaire. It is a different generation and different expectation of the patients,” Schroeder said.
Because of the lack of medical literature about sexual function after surgery for AIS, patients may be forced to rely on the Internet to have their questions about this issue answered, Schroeder noted.
“If you are trying to look in the medical literature about updated data, there is pretty much nothing out there. So patients go the modern way,” he said. “They go to all kinds of blogs.”
Questionnaires administered
Schroeder and colleagues compared 40 patients who underwent surgery for AIS with a control group at 8 years postoperatively. A certified sexologist/gynecologist led the study and a female medical student distributed the questionnaires to patients, which included the Female Sexual Distress Scale (FSDS) and the Female Sexual Function Index (FSFI). A score of more than 10% on the FSDS scale signals a problem, according to Schroeder.
Patients who were aged 24 years, average, underwent posterior-only fusion and had average Cobb angles of 55°.
The overall FSDS score of 7.05 points in both groups was higher than in the general population. Twenty-five percent of the AIS group had an FSDS score of 11 or more, as did 12% of the control group, Schroeder said.
Average FSFI scores were 24.2 points of a possible 36 points in the scoliosis patients, where 26.55 points constitutes female sexual distress. The scoliosis group’s scores were higher than in the control group. Half of the subset FSFI scores in the scoliosis patients were normal, but they had decreased scores in the other three subset measures of the index.
“One question we are now studying is ... the effect of bracing on these patients,” Schroeder said. – by Renee Blisard Buddle
- References:
- Danielsson AJ. Spine. 2003;28(18):2078-2085.
- Schroeder JE. Paper #P98. Presented at: North American Spine Society Annual Meeting; Oct. 23-27, 2012; Dallas.
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For more information:
- Josh E. Schroeder, MD, can be reached at The Orthopedic Surgery Department, Hadassah Hebrew University Medical Center, Kiryat Hadassah, POB 12000, Jerusalem, 91120, Israel; email: jes@hadassah.org.il.
Disclosure: Schroeder has no relevant financial disclosures. The project was supported by a Scoliosis Research Society grant.