Male sexual function after bilateral internal iliac artery embolization for pelvic fracture.

Abstract

Bilateral internal iliac artery embolization (BIIAE) effectively controls unlocalized bleeding from pelvic fractures. Its short-term safety has been documented, but its long-term effect on urogenital function has not been evaluated. Patients having temporary BIIAE with gelatin sponge slurry for pelvic fractures were prospectively identified. Two control groups were created--one with similar pelvic fractures but no embolization, and the other with nonpelvic injuries. The groups were matched for risks of urogenital dysfunction: age, time elapsed since injury, Injury Severity Score, pelvic Abbreviated Injury Scale score, and presence of urethral or bladder injuries. Urogenital function was assessed at least 1 year after injury using a validated questionnaire. Sexual function was significantly compromised in patients having pelvic fractures compared with those not having fractures. There was no difference in sexual function between patients having pelvic fractures treated with BIIAE and those having pelvic fractures alone. BIIAE does not produce lasting adverse effects on urogenital function. Sexual dysfunction frequently occurs after traumatic pelvic fracture and is produced by the injury itself.