Introduction: Anterior lumbar interbody fusion (ALIF) is a well-established procedure for the treatment of spondylosis, spondylolisthesis, and degenerative disc disease, but can cause sexual dysfunction and retrograde ejaculation (RE). We aimed to assess the occurrence of sexual dysfunction and RE, and to measure patient satisfaction after ALIF, as well as to explore associations between these factors.
Methods: A short questionnaire on change in sexual function, RE and patient satisfaction was sent to 170 male patients aged 18-60 years who underwent a primary ALIF at L5/S1, L4/L5, or L5/S1 + L4/L5 via retroperitoneal approach between 2015-2020. Clinical data was extracted from the electronic patient system and associations were assessed using logistic regression.
Results: Of the 170 patients contacted, 98 (58%) agreed to participate. The most frequent fusion level was L5/S1 (n=74, 76% of respondents) and InductOs was generally used (n=69, 70%). Overall, 21 patients (21%) reported a change in sexual function and 11 (11%) felt signs of RE. The majority of patients was satisfied with the surgical outcome (n=83, 85%) and would redo the surgery (n=83, 85%). The odds of being satisfied with the surgery were 4x higher for patients who did not observe a change in sexual function than those who did (95% confidence interval 1.24–12.86).
Discussion: The risk of sexual dysfunction and RE after ALIF is relevant and patients need to be adequately informed about these complications, especially if they desire to have children. At the same time, the ALIF procedure remains a successful treatment option with high patient satisfaction.