Incidence of Erectile Dysfunction in Patient with Pelvic Fracture and Posterior Urethral Distraction Defects and Colour Doppler Correlation in Preoperative and Postoperative Period
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1387-1394
Background: Pelvic injuries are a component of major Road traffic accidents. Erectile dysfunction together with stricture formation and urinary incontinence form a triad of deleterious consequences that affect patients sustaining a pelvic fracture urethral injury (PFUI). There is also a difficulty in differentiating erectile dysfunction due to PFUI and de novo erectile dysfunction due to urethral realignment or delayed urethroplasty, unless patients are assessed for erectile dysfunction at several times, ideally before and after injury as well as before and after repair. In this study, we try to find the incidence, probable cause and impact of surgery for urethral stricture on erectile dysfunction in patients with post traumatic urethral stricture due to pelvic fracture.
Materials & Methods: A randomized prospective observation study done on 33 patients of pelvic trauma (pelvic fracture) with urethral injury and pelvic fracture without urethral injury at NSCB medical college & hospital, Jabalpur, from January 2019 to august 2020. All patients with pelvic fracture were divided into two groups- Group A- Pelvic trauma (pelvic fracture) with posterior urethral Distraction injury and Group B- Pelvic fracture without urethral injury. Patients who were having erectile dysfunction were subjected to preoperative penile colour doppler. Colour doppler was done 3 months after the trauma, when the patient was admitted for urethroplasty.
Results: The total number of cases was 33. Of 23 patients had pelvic fracture with urethral injuries and 10 patients had only pelvic fracture. Majority of patients belonged to younger age group (42.42%) as they are more prone to road traffic injuries. The incidence of erectile dysfunction is 33.33%. The incidence is 39.13%. Out of which, 6 patients developed vasculogenic erectile dysfunction (incidence 26%) and 3 patients developed neurogenic/psychogenic erectile dysfunction (incidence 13%).
Conclusion: We concluded that pelvic fracture with urethral injuries is associated with higher incidence of erectile dysfunction (P-value 0.042). Pelvic fracture alone also has association with erectile dysfunction but not significant (P-value0.476). Vasculogenic erectile dysfunction is more common than neurogenic /psychogenic erectile dysfunction in patients with pelvic fracture. Surgery for urethral stricture (urethroplasty) is not associated with any improvement or deterioration in erectile function in these patients (P-value1).
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