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Lumbosacral radicular pain during micturition, defecation or orgasm
Author(s) -
Haddad Rebecca,
Hentzen Claire,
Le Breton Frederique,
Sheikh Ismael Samer,
Amarenco Gerard
Publication year - 2019
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1372
Subject(s) - medicine , urination , defecation , radicular pain , lumbar , constipation , pelvic pain , lumbosacral joint , conus medullaris , spinal cord , surgery , urinary system , psychiatry
Background The objective of this study was to describe, in a cohort of patients followed for bladder, bowel or sexual dysfunctions, the occurrence of radicular pain during micturition, defecation and/or orgasm. Methods The study included all patients referred in our neuro‐urology department and who suffered from radicular pain before, during or after micturition, defecation and/or orgasm. Data included demographic and medical variables, urodynamic and perineal electromyographic diagnosis. Results A total of 30 patients (men: 70%, mean age 45.4 ± 11.8,) complained of radicular pain before, during or after orgasm (51.4%), micturition (34.3%), or defecation (14.3%). In 30% of cases, radiculopathy was found and was predicted by micturition pain. Other pathologies were as follows: vertebral (16.5%), pelvis and sacral (16.5%), inflammatory central nervous system (10%) lesions and peripheral neuropathies (6.7%). Neurological level of injury was between the lumbar and the sacral level. All spinal cord lesions were lesions of the conus medullaris. Patients also complained of lower urinary tract symptoms (70%), sexual (63.3%) and bowel (60%) disorders. In most cases, the urodynamic diagnosis was neurogenic bladder with peripheral abnormalities and the electromyographic diagnosis was distal neuropathy. Conclusion Radicular pain occurring during micturition, defecation or orgasm is a rare condition. The most common underlying lesion seems to be radiculopathy, from lumbar to sacral spine. The presence of these symptoms, in the absence of any known neurological condition, should suggest the practitioner a radiculopathy in most of the cases. In consequence, appropriate additional tests should be offered to these patients. Significance Few data are available on sciatica during micturition, defecation or orgasm. This study underlines the need for appropriate tests if a patient complaint from this type of symptom. Indeed, the most common underlying lesion is a radiculopathy but can also be a lesion of conus medullaris.