Résumé
Le diagnostic d’un syndrome de la queue-de-cheval (SQC) est défini par l’existence d’une atteinte urinaire et/ou anorectale ainsi qu’à des troubles sensitifs périnéaux. Ses conséquences sexuelles ne sont appréciées que tardivement, souvent en postopératoire, à distance de l’apparition des symptômes neurologiques et/ou urogénitaux. Les troubles sexuels dans les SQC sont peu documentés, mais leur fréquence est très importante chez l’homme autant que chez la femme. La présence de troubles sensitifs est une source importante d’insatisfaction dans le domaine sexuel, particulièrement chez les femmes. Chez l’homme, la diminution de l’orgasme et la dysfonction érectile sont les plaintes sexuelles les plus fréquemment rencontrés. Les troubles de l’éjaculation sont plus rares. Ces troubles sexuels sont très souvent associés à une symptomatologie urinaire. Chez la femme, les plaintes les plus fréquemment rencontrées sont une diminution, voire une perte de la lubrification, une importante diminution de la libido, ainsi que de la sensation orgasmique, mais un tableau douloureux local est fréquemment associé. Les troubles sexuels dans le SQC sont permanents et le plus souvent définitifs. Une prise en charge globale est nécessaire surtout dans une population qui garde le plus souvent un handicap moteur peu important et qui souhaite retrouver une sexualité.
Abstract
Cauda equina syndrome (CES) is diagnosed in cases of urinary and/or anorectal dysfunction accompanied by loss of sensation in the perineum. The effect on sexual function is not normally discovered until later, often during the postoperative period, some considerable time after the onset of neurological and/or urogenital symptoms. There are few reports concerning sexual problems in CES, yet they are very common in both men and women. Loss of feeling is a significant source of sexual dissatisfaction, particularly in women. The most frequent sexual disorders reported by men are reduction in orgasm and erectile dysfunction. Ejaculatory disorders are less common. Sexual problems are often accompanied by urinary symptoms. Women most often report reduced or absent lubrication and significantly diminished libido and orgasm, often associated with local pain. Sexual dysfunction in CES is permanent and often incurable. Aglobal approach to treatment is needed, particularly where the population suffers little motor disability and wishes to regain sexual function.
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Scheiber-Nogueira, M.C. Troubles sexuels et syndrome de la queue-de-cheval. Pelv Perineol 4, 191–195 (2009). https://doi.org/10.1007/s11608-009-0249-6
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DOI: https://doi.org/10.1007/s11608-009-0249-6