Sexual health after lumbar discectomy in younger patients—What can they expect? A prospective cohort study using patient-reported outcome data

Sexual health is an important aspect of wellbeing and is often impaired in younger adults with lumbar disc herniation (LDH). Evidence describing postoperative sexual health specifically in this age group remains limited. How does self-reported sexual health change from before to one year after lumbar discectomy in patients aged 18–50? This cohort study used prospectively data from the Danish registry DaneSpine. Patients aged 18–50 undergoing single-level lumbar discectomy between 2010–2022 were included. The primary outcome was sexual health measured using ODI item 8 (“My sex life is?”). Secondary outcomes were visual analogue scale (VAS) scores for back and leg pain. Changes from baseline to one year were analyzed with Wilcoxon signed-rank tests (ODI item 8) and paired t-tests (VAS). A total of 1,599 patients were included (mean age 38.5 years; 47.4% female). Preoperatively, 54.7% reported a severely restricted, nearly absent, or absent sex life due to pain. Mean VAS scores were 47.5 for back pain and 70.5 for leg pain. At one year, only 11.7% reported severely restricted or worse sexual health (p < 0.001). In contrast, 53.1% reported a normal sex life without extra pain and 25.8% reported a normal sex life with some extra pain. VAS scores improved to 29.3 (back) and 24.9 (leg) (p < 0.001). Younger adults with LDH experience improvement in pain-related sexual dysfunction after lumbar discectomy. One year postoperatively, more than 78% report a normal or nearly normal sex life. • This is a cohort study focusing on younger adults (18–50) undergoing lumbar discectomy and their postoperative sexual health. • More than half of all patients reported severe pain-related sexual dysfunction before surgery. • At one year, only 11.7% continued to report severely restricted or absent sex life, representing a major postoperative improvement. • Over 78% of patients reported a normal or nearly normal sex life after lumbar discectomy. • Pain scores for both back and leg pain improved significantly and paralleled improvements in sexual health. • Results provide counseling material for clinicians treating younger patients with LDH and pain-related sexual dysfunction.