Male sexual dysfunction after pelvic fracture.

BACKGROUND: The assessment of multiple aspects of male sexual function after pelvic fracture.

METHODS: A cross-sectional retrospective study of male sexual function was conducted. Patients admitted with traumatic pelvic fracture between January 1995 and June 2001 were included. One hundred and two patients were invited by mail. After performing a standardized clinical examination including an interview, the patients were asked to answer a questionnaire at home. Sexual dysfunction was classified as erectile dysfunction (ED), ejaculatory dysfunction, sensory loss in genital region, and pain during sexual activity. ED was assessed by the International Index of Erectile Function (IIEF). The pelvic injury was classified using Tile's classification.

RESULTS: Complete data of 77 men were available (age 35 +/- 13). A total of 47 patients (61%) reported limitations in sexual function. Persistent ED was found in 15 patients (19%). The patient's report of ED could be verified by a low IIEF score in 14 cases. Injury patterns, which may increase the incidence of sexual dysfunction, could be identified. A ruptured symphysis appeared to bear a risk of temporary ED. Comparing compression and distraction in type B injuries, patients with distraction injury showed more severe sexual function. Posterior ring disruptions seemed to increase the risk of persistent problems, possibly caused by nerve damage.

CONCLUSIONS: This study emphasizes that major pelvic trauma may impair sexual function in men. The results demonstrate an objective measurement of ED by the IIEF as well as an extended spectrum of complaints. The IIEF questionnaire might be considered to identify patients that need further medical evaluation.