MP79-20 RISK STRATIFICATION FOR ERECTILE DYSFUNCTION AFTER PELVIC FRACTURE URETHRAL INJURIES: A PILOT STUDY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) I1 Apr 2017MP79-20 RISK STRATIFICATION FOR ERECTILE DYSFUNCTION AFTER PELVIC FRACTURE URETHRAL INJURIES: A PILOT STUDY Paul H Chung, Cody Gehring, Reza Firoozabadi, and Bryan B Voelzke Paul H ChungPaul H Chung More articles by this author , Cody GehringCody Gehring More articles by this author , Reza FiroozabadiReza Firoozabadi More articles by this author , and Bryan B VoelzkeBryan B Voelzke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2504AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Pelvic fractures with associated urethral injuries are associated with a high risk of erectile dysfunction (ED) perhaps due to the proximity of the cavernosal nerve to the bulbomembranous junction. We sought to compare the frequency and severity of new onset ED in pelvic fracture patients with and without urethral injuries and to identify potential risk factors for ED in the setting of pelvic injury. METHODS A retrospective analysis was conducted evaluating male patients treated for pelvic fractures with and without urethral injury at a level 1 trauma center between 2005 and 2016. The International Index of Erectile Function (IIEF) questionnaire was administered by telephone to assess post-injury ED. Additional questions regarding pre-injury sexual function, glans vascular symptoms, glans sensitivity, and an updated past medical history were also administered. A diagnosis of new onset ED was defined as the patient having no recollection of ED prior to injury and subsequently having an IIEF score of <22 after injury. Glans vascular symptoms were defined as having a cold glans during an erection. Penile sensitivity was described as either decreased or increased sensitivity of the glans penis. RESULTS Of the 118 patients, 42% (50/118) patients responded to the questionnaire: 21 (42%) with pelvic fracture urethral injuries (PFUI) and 29 (58%) with pelvic fractures alone. We observed a numerical increase in new-onset ED in the PFUI group (n=12, 57%) when compared to the pelvic fracture alone group (n=11, 38%, p=0.29). The mean post-injury IIEF score was higher for the PFUI group (18 ± 7.6) than the pelvic fracture alone group (13 ± 8.7, p=0.05), with the PFUI patients more frequently developing severe ED (IIEF <7) (p<0.05). There were no significant differences in glans vascular symptoms (p=0.33) or penile sensitivity (p=0.17) between the two groups. Age, comorbidities, concomitant injuries, pelvic fracture pattern, and need for pelvic angioembolization were not risk factors for developing ED in either cohort. CONCLUSIONS ED was more severe in patients with PFUI compared to patients with pelvic fractures alone. Based on our results, a larger prospective analysis is warranted to better characterize ED in pelvic fracture patients. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1080 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Paul H Chung More articles by this author Cody Gehring More articles by this author Reza Firoozabadi More articles by this author Bryan B Voelzke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...