Unpleasant side-effects which may occur post-operatively are: disturbances of urination and bladder atony, often in two phases. Babchin (1929) reports an incidence of 70%, but the duration is not long, except in individual cases, which are the exception (Sjoquist reported a duration of 1 year).
Some surgeons (Babchin, 1929, Sasaki 1938) have observed in their operated cases temporary weakening of the anal sphincter and an inability to distinguish flatulence from defaecation. Paralytic ileus has also been observed. I have seen this on two occasions, but it was temporary and receded quickly, without any serious after-effects.
An undesirable phenomenon is root pain in the operative region. This has been observed in five out of fifteen operated patients, but was of short duration (5—14 days). I do not think that this post-operative finding was due to operative root damage.
Rarely, the operated patients have complained of difficulties on standing, due to orthostatic hypotension. Unavoidably, operated males also complain of loss of libido and ability to have an orgasm, despite a maintained ability of erection and ejaculation. This can occur even with a unilateral operation. On the other hand, White and Sweet have reported that their unilateral operated males showed completely unimpaired sexual function immediately after discharge from hospital. There is also a loss of libido and orgasm in women. From these experiences — even if they are rare — it can be seen that the patient must be informed preoperatively.
Weakness of the lower extremities has been observed by some surgeons in 5—29% of patients (Babchin, 1936). This, however, improved before the patient returned to a normal life. One can sometimes observe ipsilateral paresis immediately after the start of sectioning; this is an indication that sectioning should be discontinued. Very rare cases of permanent weakness of the extremities indicate that there has been a disturbance in blood supply of the pyramidal region. Such an explanation is very acceptable and probable. Thrombosis of the anterior spinal artery may also produce such weakness in the postoperative period.