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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 8/2012

01-08-2012 | Disruptions of the Pelvic Ring: An Update

High Rates of Sexual and Urinary Dysfunction After Surgically Treated Displaced Pelvic Ring Injuries

Authors: Adekoyejo A. Odutola, FRCS(Orth), Omar Sabri, FRCS(Orth), Ruth Halliday, Timothy J. S. Chesser, FRCS(Orth), Anthony J. Ward, FRCS

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2012

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Abstract

Background

Pelvic ring injuries may be associated with genitourinary injury (GUI) and result in urinary or sexual dysfunction.

Questions/purposes

We determined (1) incidence of new sexual and urinary dysfunction after surgically treated pelvic ring injuries, (2) association of sexual or urinary dysfunction to fracture type and GUI, and (3) incidence and association between new sexual and urinary dysfunction in male and female patients without GUI.

Methods

We retrospectively studied 151 patients by postal questionnaire after pelvic reconstruction. Presence, type, and severity of new sexual dysfunction and urinary dysfunction were related to GUI and type of pelvic fracture using the Young and Burgess classification. Minimum followup was 1 year (median, 5 years; range, 1–12 years).

Results

New sexual dysfunction occurred in 61 of 143 (43%) and urinary dysfunction in 61 of 150 (41%) responding patients. Neither new sexual nor urinary dysfunction was associated with sex or GUI. In patients with no GUI, new sexual dysfunction was associated with chronologic age (odds ratio [OR], 1.04/year; 95% CI, 1.01–1.07) and pelvic fracture type. Lateral compression injury was less likely to result in new sexual or urinary dysfunction compared with AP type (sexual OR, 1.73; 95% CI, 0.67–4.47; urinary OR, 2.97; 95% CI, 1.15–7.66) and vertical shear type (sexual OR, 2.60; 95% CI, 1.02–6.64; urinary OR, 4.6; 95% CI, 1.81–11.73).

Conclusions

Our data suggest new sexual and urinary dysfunction occur at relatively high rates after pelvic fracture in patients with or without GUI. We recommend early assessment and referral for specialist treatment.

Level of Evidence

Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Appendix
Available only for authorised users
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Metadata
Title
High Rates of Sexual and Urinary Dysfunction After Surgically Treated Displaced Pelvic Ring Injuries
Authors
Adekoyejo A. Odutola, FRCS(Orth)
Omar Sabri, FRCS(Orth)
Ruth Halliday
Timothy J. S. Chesser, FRCS(Orth)
Anthony J. Ward, FRCS
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 8/2012
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2257-z

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