Clinical Orthopaedics and Related Research

Clinical Orthopaedics and Related Research

High rates of sexual and urinary dysfunction after surgically treated displaced pelvic ring injuries
Odutola AA, Sabri O, Halliday R, Chesser TJS, Ward AJ. February 2012

This was a retrospective study using a postal questionnaire on 151 patients identified from pelvic injury database in Bristol UK, over a 13-year period. Median age of study group was 40 (16-76) and sex distribution was 111 males and 40 females. Median time from injury to follow-up by questionnaire was five years. Data analysis was undertaken using SPSS version 17.0, Fisher’s exact test and Pearson’s chi-square test.
The incidence of new sexual dysfunction was 43% and of urinary dysfunction was 41%, similar rates in males and females. In patients without genitourinary injury at time of surgery the incidence of new sexual dysfunction was 33% and of new urinary dysfunction was 39%. These findings were similar to previous 24 studies.
This survey found an association between the type of pelvic injury and the incidence of new sexual and urinary dysfunction with higher rates for antero-posterior compression and vertical shear fractures.
Limitations of the study were problems in follow-up in a retrospective study and lack of consensus on the definition and of validated assessment tools. Also there were no control subjects without pelvic ring injuries and they did not evaluate the presence of associated injury, chronic pelvic pain or co-morbidities that may affect sexual dysfunction.
The paper suggests that new sexual and urinary dysfunction occur at relatively high rates after pelvic fracture. The recommendation is early assessment and referral for specialist treatment.

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