Erectile dysfunction and penile rehabilitation after pelvic fracture: a systematic review and meta-analysis

Schmid, Florian; Held, Ulrike; Eberli, Daniel; Pape, Hans-Christian; Halvachizadeh, Sascha

doi:10.1136/bmjopen-2020-045117

Cited by 8 publications

(7 citation statements)

References 73 publications

(77 reference statements)

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“…Dysfunction of the pelvic ring after trauma can lead to functional limitations of non-specific daily activities like walking, standing, sitting and disbalance of the lumbosacral region [49]. Furthermore, neurological dysfunction can cause severe morbidity and has a significant negative prognostic value of quality of life [50][51][52]. Hence, early anatomic reduction and stabilization may be associated with an improved neurological recovery [50].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up after Iliosacral Screw Fixation of Unstable Pelvic Ring Fractures

Stolberg-Stolberg,

Lodde,

Seiß

et al. 2024

JCM

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(1) Background: High-energy injuries of the pelvic ring are rare. The wide application of iliosacral screw fixation of the posterior pelvic ring is relatively new. The aim of the present study was to evaluate the long-term quality of life. (2) Methods: All patients treated with an iliosacral screw for a posterior pelvic ring stabilization after high-energy trauma at a level 1 trauma center between 2005 and 2015 were included. Pelvic ring injuries were classified according to the Tile classification adapted by AO/ASIF. The clinical evaluation included the patient-oriented questionnaires surveys of the Majeed Score, Iowa Pelvic Score (IPS), Work Ability Index (WAI), SF-36, EQ5D-5L. (3) Results: A total of 84 patients were included with a median follow-up of 130.1 months (IQR 95.0–162.0 months). The median ISS was 22.5 (IQR 16.0–29.0), mean Majeed Score 83.32 (SD ± 19.26), IPS 77.88 (SD ± 13.96), WAI 32.71 (SD ± 11.31), SF-36 PF 71.25 (SD ± 29.61) and EQ5D-5L 0.83 (SD ± 0.21). There was a notably difference between uni- and bilateral pelvic fractures (p = 0.033) as well as a correlation with the ISS (p = 0.043) with inferior functional outcome measured by IPS. (4) Conclusions: Long-term follow-up of iliosacral screw fixation of unstable pelvic ring fractures showed a good quality of life and functional outcome with equal EQ5D-5L results and inferior SF-36 physical functioning compared to the German population.

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow-Up after Iliosacral Screw Fixation of Unstable Pelvic Ring Fractures

Stolberg-Stolberg,

Lodde,

Seiß

et al. 2024

JCM

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“…It seems clear that type A fractures show a lower frequency of SDs than type B and C fractures, in both males and females, because the continuity of the pelvic ring is not interrupted and they do not correlate with large pelvic organ injuries [ 4 ]. Mechanism of trauma, on which is based the tile classification, seems to be crucial in the incidence of SDs [ 20 ]. In fact, in our sample of patients, group A revealed a smaller number of associated injuries, and a significantly shorter hospitalization time when compared to groups B and C. This had a positive psychophysical impact on the patient, as evidenced by the excellent results of the SF-12 quality of life questionnaire, which could be protective against the onset of SD.…”

Section: Discussionmentioning

confidence: 99%

Correlation between traumatic pelvic ring injuries and sexual dysfunctions: a multicentric retrospective study

Rovere

Smakaj

Perna

et al. 2023

International Orthopaedics (SICOT)

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Purpose Among the functional impairments associated with pelvic ring injuries (PRI), sexual dysfunction (SD) is a common clinical issue. The aim of this study is to investigate correlations between traumatic PRI, genitourinary, and sexual dysfunctions, for a proper multidisciplinary treatment. Methods We performed an observational, multicentric study, from January 2020 to 2022. We conducted a follow-up after surgery at three, six, 12, and 24 months by measuring the Female Sexual Functioning Index (FSFI), the International Index of Erectile Function (IIEF), the Arizona Sexual Experience Scale (ASEX), the Majeed Score, and the SF-12. Descriptive statistics was conducted on T-test, Whelc’s test, and one-way ANOVA which were performed when appropriate. Results A total of 76 patients (mean age 42.17 ± 15 years) were included in the study and allocated into three groups (A, B, and C). Tile A group revealed good sexual outcomes, similar to that of healthy patients. Tile B group demonstrated worsen SD than the previous group. In Tile C group, there was a longer average duration of the orthopaedic surgery when compared to group B. However, in terms of SDs, statistical significance could not be demonstrated between groups C and B. Conclusions We observed a progressive spontaneous recovery of sexual function, corresponding to each PRI group. Moreover, men classified as B2 had milder SDs than B1 male patients.

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“…The most common cause of pelvic fractures is high‐energy trauma, which includes traffic accidents, crush, and fall injuries 4 . Studies have shown that complications of pelvic fractures include chronic pain, gait disturbance, post‐traumatic osteoarthritis, and sexual dysfunction 5–10 . Early identification and effective management are crucial to patient survival and functional recovery.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Studies have shown that complications of pelvic fractures include chronic pain, gait disturbance, post‐traumatic osteoarthritis, and sexual dysfunction. 5 , 6 , 7 , 8 , 9 , 10 Early identification and effective management are crucial to patient survival and functional recovery. The management of unstable pelvic fractures is challenging, and Tile C pelvic injury is a typical unstable pelvic injury characterized by rotational and vertical instability.…”

Section: Introductionmentioning

confidence: 99%

A Countertraction Closed Reduction Technique in Minimally Invasive Fixation of Recent Type C Pelvic Ring Injuries

Liu,

Zhao,

Cheng

et al. 2024

Orthopaedic Surgery

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ObjectiveClosed reduction of pelvic injuries is a prerequisite and critical step in minimally invasive treatment. Achieving non‐invasive closed reduction of pelvic injuries is a challenging clinical problem. This study demonstrated a non‐invasive traction technique for closed reduction called countertraction closed reduction technique (CCRT) and evaluated its effectiveness for type C pelvic ring injuries.MethodThe data of patients with unstable pelvic fractures treated with CCRT and minimally invasive fixation were retrospectively reviewed from January 2017 to February 2022. Sacroiliac screws were placed to fix the posterior pelvic ring, and internal or external fixation was used to fix the anterior pelvic ring. Operation time, intraoperative blood loss, duration of hospital stay, fracture union and postoperative complications were recorded. Fracture reduction quality was evaluated using the Matta scoring criteria. Functional recovery and general quality of life were evaluated using the Majeed functional scoring criteria.ResultsThirteen patients (nine males and four females), with an average age of 49.6 years were treated with CCRT and followed up for a mean of 18.5 months. The average operation time was 137.2 minutes (range 92–195 minutes), the average intraoperative blood loss was 31.2 mL (range 10–120 mL) and the average duration of hospital stay was 14.3 days (range 4–32 days). All patients achieved bony union with an average union time of 11.9 weeks (range 10–16 weeks). According to the Matta radiographic criteria, the quality of fracture reduction was excellent in eight patients, good in four, and fair in one. The average Majeed functional score was 89.7 (range 78–100). The functional evaluation revealed that the outcomes were excellent in nine patients, and good in four patients. Complications included incision fat liquefaction in one patient, and heterotopic ossification in another patient. There were no surgical complications as a result of CCRT.ConclusionCCRT is a non‐invasive closed reduction method for minimally invasive fixation of fresh Tile C1 and C2 pelvic fractures. The advantages of CCRT combined with minimally invasive treatment include a small surgical incision, reduced intraoperative bleeding, satisfactory fracture reduction, bone healing and functional recovery.

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Erectile dysfunction and penile rehabilitation after pelvic fracture: a systematic review and meta-analysis

Cited by 8 publications

References 73 publications

Long-Term Follow-Up after Iliosacral Screw Fixation of Unstable Pelvic Ring Fractures

Long-Term Follow-Up after Iliosacral Screw Fixation of Unstable Pelvic Ring Fractures

Correlation between traumatic pelvic ring injuries and sexual dysfunctions: a multicentric retrospective study

A Countertraction Closed Reduction Technique in Minimally Invasive Fixation of Recent Type C Pelvic Ring Injuries

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