Frequency of erectile dysfunction following pelvic fracture among patients admitted to two Wits Teaching Hospitals, South Africa

Abstract

Background: Erectile dysfunction that can range from weak to severe is one of the most important sequelae of pelvic fractures and may be transient or permanent. Importantly, erectile dysfunction is more prevalent when the pelvic fracture is associated with urethral injury. This study aimed to evaluate the frequency of erectile dysfunction post pelvic fracture and determine the frequency of spontaneous recovery of erectile function within the first six months from the time of injury in a South African sample population.

Materials and Methods: This study was a cross-sectional study of records of patients who were admitted to the Orthopedic Department at Helen Joseph Academic Hospital and the Male Sexual Dysfunction Clinic at Charlotte Maxeke Johannesburg Academic Hospital, in Johannesburg, South Africa, with a pelvic fracture between July 1, 2011 and April 30, 2015.

Results: A total of 53 patients aged between 18 and 80 years (mean: 7.57 ± SD3.45) meeting the study-inclusion criteria participated in the study, of which 50.9% had a B2 type pelvic fracture and 20% had a C type fracture. Of the 53 patients, 43.4% reported erectile dysfunction. The majority (88%) of patients indicated a recovery of erectile function between 2 and 8 months after the injury. However, 86% of those patients were still suffering from other forms of sexual impairment like orgasmic dysfunction and lack of sexual satisfaction. Interestingly, sexual desire seemed to be preserved. Patients with sexual dysfunction were more likely to have had a urethral injury as well as a more severe fracture.

Conclusions: In our sample of 53 patients, almost half (43.4%) reported sexual dysfunction after a pelvic fracture. Importantly, patients with a severe pelvic fracture and urethral damage should be followed-up after surgery, as the risk of long-term sexual dysfunction is increased in these particular patients.

Keywords: pelvic fracture, erectile dysfunction, tile classification, IIEF score