Sexual dysfunction following traumatic pelvic fracture

Abstract

BACKGROUND While sexual dysfunction (SD) in men following traumatic pelvic fracture is common, little is known of how men experience changes in their sexual health after injury. The aims of the present study were to explore the personal and interpersonal impacts of SD in men after pelvic injury and to understood how interactions with the health care system can be optimized to improve patient-centered trauma survivorship care. METHODS Fifteen semistructured interviews were conducted with men who had a history of traumatic pelvic fracture and self-reported SD. Interviews were audio recorded, transcribed, and uploaded to a web-based qualitative analysis platform. A codebook was developed, and intercoder reliability was verified. Inductive thematic analysis was performed to identify notable themes related to patient postinjury sexual health experiences. RESULTS Median age of interviewees was 46 years (interquartile range, 44–54 years), with a median time since injury of 41 months (interquartile range, 22–55 months). Five primary themes were identified from the analysis: (1) effects on self-image and romantic relationships, (2) unknown care pathways and lack of communication, (3) inconsistencies with health care provider priorities, (4) provision of sexual health information and resources, and (5) the importance of setting expectations. Interviewees suggested that improved communication, provision of information related to possible adverse effects of their injuries, and expectation setting would improve posttrauma experiences. CONCLUSION Men’s experiences with SD after pelvic trauma can be heavily influenced by their interactions with health care providers and the value that is placed on sexual health as a component of survivorship. Incorporating these findings into a patient-centered trauma survivorship program may improve patient experiences. LEVEL OF EVIDENCE Therapeutic, level V.

The effect of sexual dysfunction on health-related quality of life in men following traumatic pelvic fractures

“…Prior work using the same cohort of pelvic trauma patients has shown that spontaneous return of normal sexual function more than 1 year after injury was highly unlikely and that the negative impact of a failure to address sexual health concerns in this population cannot be understated. 13,18 These findings are similar to what has been reported in men following radical prostatectomy for prostate cancer. 26 However, while there has been tremendous interest in prostate cancer survivorship with numerous prior studies prospectively examining HrQOL and ED, these efforts have been lacking in the pelvic trauma literature.…”

Understanding sexual health concerns in women after traumatic pelvic fracture

“…Provider discomfort can deter patients from sharing their concerns, thwarting the possibility of productive interactions. Similarly, in a qualitative study investigating how men navigate conversations regarding sexual health after pelvic fracture, patients felt that physicians did not want to address sexual health, ignoring or passing over raised concerns 10 …”

“…The effects of sexual dysfunction on quality of life have been well‐studied, but there are few studies that discuss the treatment patterns and utilization of healthcare services following injury. Those that do exist pertain almost exclusively to men 8–10 . As such, how women experience sexual dysfunction after traumatic injury and how they navigate the healthcare system is currently not well‐documented in the literature.…”

“…Those that do exist pertain almost exclusively to men. [8][9][10] As such, how women experience sexual dysfunction after traumatic injury and how they navigate the healthcare system is currently not well-documented in the literature. We hypothesized that sexual dysfunction is common among women with traumatic pelvic fractures and that related concerns are inadequately addressed within the healthcare system due to factors at both the patient and provider levels.…”

Acute stress disorder in patients with accidental traumatic fractures: What can we do

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Traumatic fractures are fractures caused by various exogenous traumatic events. They are characterized by suddenness and unpredictability (Johnsen et al, 2021;(Li et al, 2021b). They not only cause physical and cognitive damage to the individual, but also have an impact on their psychology, causing strong stress response, but when encountering frustration and adversity, not all individuals will have psychological problems or stress disorders, and some people will adapt well after stress (Xiao et al, 2020).

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