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Disc Herniation L5 S1.

Resolved Question:

Dear Doctor

About two years ago I was diagnosed with a herniated disc. L5 S1.. I had lots of leg pain that eventually went away. The I periodically started to have erectile issues. I saw a urologist and he didn't find much wrong. Have me cialis and it works sometimes. He said that maybe I should have surgery on my disc because that may be causing the issue. Sometimes I even get minor numbness and tingling in the groin area. Any thoughts?


Category: Urologist

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Category: Andrologist
Dr. Gautam Banga is online now

Expert:  Dr. Gautam Banga replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

I understand your concern and will try my best to help you. Inorder to provide a more solid opinion I will require some additional information from you.

1. Where you have any bladder or bowel issues with the back pain ? (As in hesitancy in urination)
2. Is there any numbness or loss of sensation around the anal region ?
3. Any weakness in legs ?
4. Do you get early morning erections ?
5. With Cialis are you able to maintain a proper erection and complete a sexual act ? (atleast occasionally ?)

You can reply as a followup
Thank you


Patient replied :

Thank you for your response. Please find my answers below.

1. Where you have any bladder or bowel issues with the back pain ? (As in hesitancy in urination) - I have had no bladder or bowel issues.
2. Is there any numbness or loss of sensation around the anal region ?
No numbness or loss of sensation around the anal region.
3. Any weakness in legs ? No weakness in legs.
4. Do you get early morning erections ? I have not been getting early morning erections. Every now and then. But not really.
5. With Cialis are you able to maintain a proper erection and complete a sexual act ? (atleast occasionally ?) Occasionally yes. But I took a 20 mg Cialis pill one day and went to have sex. Got hard during foreplay and then it went down.. Then a little later was able to have sex.


Expert:  Dr. Gautam Banga replied 3 Days.

Hello,

Thank you for the details. It does not seem that the L5-S1 disc problem is causing the Erectile dysfunction. There are no other signs of Neurological dysfunction. WIthout other neurological symptoms an ED will not occur in a disc bulge or herniation. Being said that you will need some tests to confirm this.

You do have occasional early morning erections and erectile with the medication. So we can assume to an extent that the nerve function is still intact. As you might be aware most common causes root from psychological reasons in case of ED.

As a first step you need to do some testings- Hormonal testing like S.testosterone, Nocturnal penile tumescence testing and
Duplex Doppler imaging. This will rule out the major organic causes (including a neurological cause). Most cases of ED can be treated successfully, so do not worry.

Hope this helps
Feel free to ask followups or clarifications
Thank you


Dr. Gautam Banga
Category: Andrologist
Experience: 
MS Surgery: MGM Medical College & M.Y Hospital Indore
Residency: M.Ch, Urology, SMS Medical College & Hospitals Jaipur
Medical School: MBBS, BJ Medical College, Pune, 2001
Training in Urethral Reconstructive surgery: Kulkarni Reconstructive Urology center, Pune
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