Erectile dysfunction after acetabular fracture.

Iain S Elliott, Conor Kleweno, Julie Agel, Max Coale, Joseph T Patterson, Reza Firoozabadi, Michael Githens, Niels V Johnsen
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Abstract

Objectives: To determine the rate of erectile dysfunction in male patients who have sustained an acetabular fracture with no previously identified urogenital injury.

Design: Cross-sectional survey.

Setting: Level 1 Trauma Center.

Patients/participants: All male patients treated for acetabular fracture without urogenital injury.

Intervention: The International Index of Erectile Function (IIEF), a validated patient-reported outcome measure for male sexual function, was administered to all patients.

Main outcome measurements: Patients were asked to complete the International Index of Erectile Function score for both preinjury and current sexual function, and the erectile function (EF) domain was used to quantify the degree of erectile dysfunction. Fractures were classified according the OTA/AO classification schema, fracture classification, injury severity score, race, and treatment details, including surgical approach were collected from the database.

Results: Ninety-two men with acetabular fractures without previously diagnosed urogenital injury responded to the survey at a minimum of 12 months and an average of 43 ± 21 months postinjury. The mean age was 53 ± 15 years. 39.8% of patients developed moderate-to-severe erectile dysfunction after injury. The mean EF domain score decreased 5.02 ± 1.73 points, which is greater than the minimum clinically important difference of 4. Increased injury severity score and associated fracture pattern were predictive of decreased EF score.

Conclusion: Patients with acetabular fractures have an increased rate of erectile dysfunction at intermediate-term follow-up. The orthopaedic trauma surgeon treating these injuries should be aware of this as a potential associated injury, ask their patients about their function, and make appropriate referrals.

Level of evidence: III.

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髋臼骨折后勃起功能障碍。
目的:确定男性髋臼骨折患者既往未发现泌尿生殖系统损伤后勃起功能障碍的发生率。设计:横断面调查。地点:一级创伤中心。患者/参与者:所有接受髋臼骨折治疗且无泌尿生殖系统损伤的男性患者。干预:对所有患者实施国际勃起功能指数(IIEF),这是一种经过验证的患者报告的男性性功能结果测量。主要结果测量:要求患者完成损伤前和当前性功能的国际勃起功能指数评分,并使用勃起功能域(EF)来量化勃起功能障碍的程度。根据OTA/AO分类方案、骨折分类、损伤严重程度评分、种族和治疗细节(包括手术入路)从数据库中收集骨折分类。结果:92例髋臼骨折患者在受伤后至少12个月,平均43±21个月接受了调查,但之前没有诊断出泌尿生殖系统损伤。平均年龄53±15岁。39.8%的患者伤后出现中度至重度勃起功能障碍。EF域评分平均下降5.02±1.73分,大于最小临床重要差异4分。损伤严重程度评分升高和相关骨折类型可预测EF评分降低。结论:髋臼骨折患者在中期随访中出现勃起功能障碍的比例增加。治疗这些损伤的骨科创伤外科医生应该意识到这是一种潜在的相关损伤,询问他们的病人关于他们的功能,并做出适当的转诊。证据水平:III。
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