The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures

Guan, Yanhua; Sun, Wenchuan; Zhao, Shengtian; Liu, Tongyan; Liu, Yuqiang; Zhang, Xiulin; Yuan, Ming

doi:10.1590/s1677-5538.ibju.2014.0170

Cited by 27 publications

(28 citation statements)

References 27 publications

(44 reference statements)

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“…It has been reported that 3% of cases of ED may result from pelvic fractures or perineal blunt trauma (25). It is assumed that ED caused by such reasons is due to lesions of the cavernous nerves or branches of the internal pudendal arteries that pass in close proximity to the pelvic bones and posterior urethra (26). Combined with this study, tumor resection involved with inferior ramus of pubis could probably affect the branches of the internal pudendal arteries.…”

Section: Discussionsupporting

confidence: 51%

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

et al. 2020

Preprint

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Background This study is to present and evaluate the short-term clinical outcomes and associated complications of 3D-printed customized prostheses for pubic defect reconstruction. Methods 5 patients receiving type III hemipelvectomy and three-dimensional-printed customized prosthesis reconstruction at our institution between 2017 and 2019 were retrospectively analyzed in this study. The operation time and blood loss during operation were recorded. The local and functional recovery was assessed by the physical examination and Musculoskeletal Tumor Society (MSTS) score. The prosthetic position and Osseointegration were evaluated by imaging examination. Oncology result and complications were recorded. Functional comparisons with MSTS score of patients grouped by resection extent were done. Results Of 5 cases, the prosthese consist of the type with stem (3, 60%) and the type without stem (2, 40%). Mean follow-up period was 17.6 months (range, 10–26 months). All 5 patients were alive with no evidence of disease. No deep infection and local recurrence occurred. The mean blood loss and mean intraoperative time was 1680 ml (range, 300 to 3700 ml) and 294 min (range, 180 to 430 min). The mean functional MSTS score at the final follow-up was 29.8 (range, 29–31). 1 male patient complained erectile dysfunction. Fretting wear around prosthetic stem was found in 3 patients while bone wear on the normal side pubis was found in 2 patients. Osseointegration was observed in all patients. Conclusion 3D-printed customized prostheses could be a feasible option to reconstruct the pubic bone defects after type III hemipelvectomy. The good outcomes are inseparable from precision prostheses design and strict surgical procedures.

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Section: Discussionsupporting

confidence: 51%

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

et al. 2020

Preprint

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“…NPT tests were executed on two hundred and sixty patients with the Rigiscan® device (Timm Medical Technologies, Inc, Eden Prairie, MN, USA) . To guarantee the exactness of the examination, all patients were demanded to avoid insomnia, drinking caffeine, or alcohol intake and to empty the bladder before falling asleep.…”

Section: Methodsmentioning

confidence: 99%

Significance of blood lipid parameters as effective markers for arteriogenic erectile dysfunction

Zhang

et al. 2020

Andrology

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Objectives The aim of the study was to investigate the ability of the blood lipid parameters to predict the discrimination of arteriogenic erectile dysfunction (ED). Materials and methods 260 subjects with ED and 60 healthy controls were enrolled. Eight lipid parameters, including total cholesterol (TC), triglycerides (TG), LDL‐C, HDL‐C, non‐HDL‐C, TC/HDL ratio, TG/HDL ratio, and LDL/HDL ratio, together with other plasma biomarkers like sex hormones were measured in all participants. Nocturnal penile tumescence (NPT), penile color Doppler ultrasonography (pDUS), and neurophysiological tests were conducted in the ED group. Results Forty‐four ED patients with normal NPT, and 84 with normal vasculature or mixed vascular abnormalities were excluded. The remaining 132 men were classified into two groups, arteriogenic ED (n = 87) and venous leakage (n = 45), by pDUS. TC/HDL, LDL/HDL, and LDL‐C were significantly higher (P < .05) and HDL‐C was significantly lower (P < .05) in the arteriogenic ED group when compared with the venous and the control groups. Receiver operating characteristic curve analysis identified area under the curve values that were predictive of arteriogenic ED for: TC/HDL and LDL/HDL 0.720 and 0.737, TC/HDL ≥ 3.73 and LDL/HDL ≥ 2.01 (sensitivity: 56.3%; specificity: 83.3% vs sensitivity: 55.2%; specificity: 91.7%), HDL‐C (0.791), ≤1.25 mmol/L (sensitivity: 69%; specificity: 81.7%), LDL‐C (0.641), ≥2.41 mmol/L (sensitivity: 55.2%; specificity: 76.7%).In the arteriogenic ED group, a significant inverse correlation was detected between TC/HDL, LDL/HDL, LDL‐C and 10‐minutes peak systolic velocity (PSV) (All P < .01)and a significant positive correlation was recognized between HDL‐C and 10‐minutes PSV(P < .01). Multivariate step wise linear regression indicated lipid parameters of LDL/HDL and HDL‐C were significantly associated with 10‐MinPSV (P < .01). Conclusion These findings suggest the LDL/HDL and HDL‐C might be a powerful indicator to predict and diagnose arteriogenic ED, and lipid‐lowing therapy should be considered for these patients.

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“…Vasculogenic ED can be further divided into; arterial insufficiency, venous leak or both. Reporting of the aetiology of PPF-ED is also variable due to the differing diagnostic techniques ( 284 ). PPF-ED is due to vascular injury in @45% (11–80%) and neurological injury in @71% (20–89%) ( 238 , 263 , 277 , 283 , 284 , 288 , 289 ).…”

Section: Post-pelvic Fracture Edmentioning

confidence: 99%

“…Arteriogenic ED may occur from fracture-related injury to the main trunk of the internal pudendal artery, to the penile artery as it passes through the perineal membrane, or to the accessory pudendal artery. Venogenic ED is consequent to damage to the corporal bodies resulting in corpora-veno occlusive dysfunction and/or penile venous leakage ( 231 , 284 , 289 , 292 , 293 ).…”

Section: Post-pelvic Fracture Edmentioning

confidence: 99%

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

Barratt

Bernard

Mundy

et al. 2018

Transl. Androl. Urol.

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Pelvic fracture urethral injury (PFUI) management in male adults and children is controversial. The jury is still out on the best way to manage these injuries in the short and long-term to minimise complications and optimise outcomes. There is also little in the urological literature about pelvic fractures themselves, their causes, grading systems, associated injuries and the mechanism of PFUI. A review of pelvic fracture and male PFUI literature since 1757 was performed to determine pelvic fracture classification, associated injuries and, PFUI classification and management. The outcomes of; suprapubic catheter (SPC) insertion alone, primary open surgical repair (POSR), delayed primary open surgical repair (DPOSR), primary open realignment (POR), primary endoscopic realignment (PER), delayed endoscopic treatment (DET) and delayed urethroplasty (DU) in male adults and children in all major series have been reviewed and collated for rates of restricture (RS), erectile dysfunction (ED) and urinary incontinence (UI). For SPC, POSR, DPOSR, POR, PER, DET and DU; (I) mean RS rate was 97.9%, 53.9%, 18%, 58.3%, 62.0%, 80.2%, 14.4%; (II) mean ED rate was 25.6%, 22.5%, 71%, 37.2%, 23.6%, 31.9%, 12.7%; (III) mean UI rate was 6.7%, 13.6%, 0%, 14.5%, 4.1%, 4.1%, 6.8%; (IV) mean FU in months was 46.3, 29.4, 12, 61, 31.4, 31.8, 54.9. For males with PFUI restricture and new onset ED is lowest following DU whilst UI is lowest following DPOSR. On balance DU offers the best overall outcomes and should be the treatment of choice for PFUI.

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The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures

Cited by 27 publications

References 27 publications

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

Three-dimensional-printed customized prosthesis for pubic defect: Clinical outcomes in 5 cases at a mean follow-up of 17 months

Significance of blood lipid parameters as effective markers for arteriogenic erectile dysfunction

Pelvic fracture urethral injury in males—mechanisms of injury, management options and outcomes

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