Brief Answer:
Studies do not show improvement in ED following surgery

Detailed Answer:
Good morning. I am a neurologist and have read your inquiry. I've also read the response of my colleague Dr. Panwar. I think he has made reasonable requests for information regarding more precise information if you can provide on the spinal column, however, I can tell you that the concept of improving erectile dysfunction in patients with lumbar canal stenosis due to osteoarthritis and degenerative changes etc. has been closely looked at.

Unfortunately, the results are somewhat controversial and range from CLEARLY NOT SUPPORTIVE to POSITIVE OUTCOMES if surgical decompression is used in patients with at most MILD symptoms of erectile dysfunction.

Despite best efforts, surgical decompression of the lumbar spinal region (where nerves are located for erectile function) not only did this particular NEGATIVE STUDY not show improvement following surgery but the test population actually got worse. The mechanism for this surprising result is not clearly understood. I believe that one possible reason why such a procedure would not work is if there are other risk factors that can cause neuropathy of that system....such as diabetes.

I know what you're going to say, "But doc, it's been under great control....that can't be the problem."

So the party line on the consequences of having diabetes mellitus is that no matter whether it's under Perfect, Excellent, Great, Good, Fair, or Poor control there are many functions which still happen to deteriorate despite the patient doing all the right things. We believe that is because even though overall average fingersticks are OK....that doesn't tell us what's happening 24 hrs. a day and just HAVING DIABETES puts a person at risk for complications as time goes on just by HAVING THE DIABETES. Make sense? I know a lot of folks have trouble embracing that fact.....diabetes is under control.....HOWEVER, changes still keep rolling along...maybe not as fast.....but just as frequently.

I'm skeptical as to exactly what a urologist could do for you. If anybody is going to operate for something like this then, I would say it should be either an orthopod or neurosurgeon.

BOTTOM LINE: There are studies which have looked at offering aggressive means of improving patients ability to cope with Erectile Dysfunction and how surgery on spinal stenosis or nerve root impingement can relate. In those studies if patients were chosen who had mild erectile dysfunction then, decompressive surgery seemed to definitely work for up to 9 months and improved the patient's quality of life. However, following surgery and after several months of improvement there are as many people who may experience either NO CHANGE or WORSENING SYMPTOMS of Erectile Dysfunction. And for those reasons I would say that lumbar surgery (or really any on the spinal column) is just as likely as not to confer improvements on someone IF THEY HAVE SUBTLE OR MILD symptoms of ED. Beyond that...there seems to be compelling evidence that ED either fails to get better or clearly GETS WORSE and there's no good way of predicting which of those 2 groups you would be in except to say from the first study that if your ED were considered MILD that you'd have a better probability of being in the at least FAILS TO GET BETTER GROUP or GETS better group vs. the clearly GETS WORSE group.



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The query has required a total of 43 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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