Quality of life after endoscopic lumbar sympathectomy for primary plantar hyperhidrosis

World J Surg. 2015 Apr;39(4):905-11. doi: 10.1007/s00268-014-2885-4.


Background: Primary plantar hyperhidrosis is characterised by excessive secretion of the sweat glands of the feet and may lead to significant limitations in private and professional lifestyle. The aim of this prospective study was to assess the effect of endoscopic lumbar sympathectomy (ESL) on the quality of life (QL) of patients with primary plantar hyperhidrosis.

Methods: Bilateral ESL was performed on 52 patients, 31 men and 21 women with primary plantar hyperhidrosis. Perioperative morbidity and clinical results were evaluated in all patients after a mean follow-up of 15 months. Postoperative QL was examined with the SF-36V2 questionnaire and the hyperhidrosis-specific questionnaires devised by Milanez de Campos and Keller.

Results: All procedures were carried out endoscopically with no perioperative morbidity. Plantar hyperhidrosis was eliminated in 50 patients (96%) and two patients (4%) suffered a relapse. Unwanted side effects occurred in the form of compensatory sweating in 34 (65%) and in the form of postsympathectomy neuralgia in 19 patients (37%). Ninety six percentage of patients were satisfied with the postoperative result and 88% would have the surgery repeated. The SF-36V2 questionnaire revealed a significant improvement of QL after lumbar sympathectomy in physical health (physical component summary, p < 0.01) as well as mental health (mental component summary, p < 0.05). Improved QL was also demonstrated in the Milanez de Campos questionnaire in the dimensions functionality/social interactions (p < 0.01), intimacy (p < 0.01), emotionality (p < 0.01) and specific circumstances (p < 0.01) as well as in the Keller questionnaire in the area of plantar hyperhidrosis (p < 0.01).

Conclusion: The performance of an ESL in patients with primary plantar hyperhidrosis leads to the effective elimination of excessive sweat secretion of the feet and to an increase in QL.

MeSH terms

  • Adolescent
  • Adult
  • Endoscopy / adverse effects
  • Endoscopy / methods
  • Female
  • Foot
  • Foot Dermatoses / surgery*
  • Health Status
  • Humans
  • Hyperhidrosis / surgery*
  • Lumbosacral Plexus / surgery*
  • Male
  • Mental Health
  • Middle Aged
  • Neuralgia / etiology
  • Prospective Studies
  • Quality of Life*
  • Recurrence
  • Surveys and Questionnaires
  • Sympathectomy / adverse effects
  • Sympathectomy / methods*
  • Treatment Outcome
  • Young Adult