High prevalence of erectile dysfunction in young male patients after intramedullary femoral nailing

Mallet, R.; Tricoire, J; Rischmann, P.; Sarramon, Jean‐Pierre; Puget, J.; Malavaud, Bernard

doi:10.1016/j.urology.2004.10.002

Cited by 28 publications

(19 citation statements)

References 17 publications

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“…Mallet et al [7] reviewed 168 patients, with femoral and tibial fractures treated with intramedullary nails on traction tables and found that the incidence of ED was as high as 40.5%. Pudendal nerve ED After Orthopedic Surgery J Curr Surg.…”

Section: Incidencementioning

confidence: 99%

“…Several studies showed a correlation between the prevalence of pudendal nerve injury and the perineal post diameter [7,9,10,13,14]. It was always smaller than the average distance separating the two ischial tuberosities in male adults (8 -10 cm).…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Mallet et al [7] reported that greater intraoperative doses of curare significantly decrease the incidence of postoperative ED, suggesting that postoperative ED could be partially prevented by optimal muscle relaxation during fracture reduction. This is particularly important in young men who have strong femoral muscles and thus require larger traction forces when compared to elderly patients with femur fractures.…”

Section: Etiopathogenesismentioning

confidence: 99%

“…Complete muscle relaxation under anesthesia is essential to reduce muscle tone, which will be advantageous in reducing the force needed during intraoperative traction. This is particularly important in young men who have strong femoral muscles and thus require larger traction forces when compared to elderly patients with femur fractures [7].…”

Section: Treatment and Preventive Measuresmentioning

confidence: 99%

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Erectile Dysfunction Secondary to Pudendal Nerve Injury Complicating Orthopedic Surgery: Practical Recommandations

2017

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Erectile dysfunction (ED) resulting from direct damage of pudendal nerve injury during orthopedic surgery is common and closely associated to the use of traction tables. Prolonged countertraction on the fracture table and the inappropriate placement of the perineal post are the two main contributing factors. Clinical signs are essentially sensitive, such as hypoesthesia of the perineum. Urinary incontinence, ED and hypoesthesia or complete anesthesia of scrotum and glans penis are the main clinical manifestations. Electrophysiological examinations should be considered when symptoms are not regressive and in cases of vesico-sphincter dysfunction and immediate severe ED. No medical treatment has demonstrated its effectiveness. Pudendal nerve decompression was reported to be useful in some cases. Preventive measures should be considered by surgeons to avoid perineal traction injuries. Patients must be clearly informed about this possible neurological complication before an operation on the orthopedic table.

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Section: Incidencementioning

confidence: 99%

Section: Etiopathogenesismentioning

confidence: 99%

Section: Etiopathogenesismentioning

confidence: 99%

Section: Treatment and Preventive Measuresmentioning

confidence: 99%

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Erectile Dysfunction Secondary to Pudendal Nerve Injury Complicating Orthopedic Surgery: Practical Recommandations

2017

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“…This is thought to be due to pudendal nerve damage caused by countertraction on the femoral head. Following intramedullary nailing of the femoral head, 40.5% of men experienced mild to moderate ED [12]. A case series of 4 men with an age range of 19-37 suffered from ED after a femoral fracture was corrected with femoral nailing.…”

Section: Etiology Of Erectile Dysfunctionmentioning

confidence: 99%

Organic Causes of Erectile Dysfunction in Men Under 40

Ludwig

Phillips²

2013

Urol Int

1,562

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There are a significant number of men under 40 who experience erectile dysfunction (ED). In the past, the vast majority of cases were thought to be psychogenic in nature. Studies have identified organic etiologies in 15-72% of men with ED under 40. Organic etiologies include vascular, neurogenic, Peyronie's disease (PD), medication side effects and endocrinologic sources. Vascular causes are commonly due to focal arterial occlusive disease. Young men with multiple sclerosis, epilepsy and trauma in close proximity to the spinal cord are at increased risk of ED. It is estimated that 8% of men with PD are under 40, with 21% of these individuals experiencing ED. Medications causing ED include antidepressants, NSAIDs and finasteride (Propecia), antiepileptics and neuroleptics. Hormonal sources are uncommon in the young population, however possible etiologies include Klinefelter's syndrome, congenital hypogonadotropic hypogonadism, and acquired hypogonadotropic hypogonadism. The workup of young men with ED should include a thorough history and physical examination. The significant prevalence of vascular etiologies of ED in young men should prompt consideration of nocturnal penile tumescence testing and penile Doppler ultrasound. Treatment options that may improve ED include exercise and oral PDE-5 inhibitors.

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Pudendal Neuralgia

Antolak¹

2008

Genitourinary Pain and Inflammation

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High prevalence of erectile dysfunction in young male patients after intramedullary femoral nailing

Cited by 28 publications

References 17 publications

Erectile Dysfunction Secondary to Pudendal Nerve Injury Complicating Orthopedic Surgery: Practical Recommandations

Erectile Dysfunction Secondary to Pudendal Nerve Injury Complicating Orthopedic Surgery: Practical Recommandations

Organic Causes of Erectile Dysfunction in Men Under 40

Pudendal Neuralgia

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