Volume : 08, Issue : 07, July – 2021

Title:

05.TO DETERMINE THE MEAN CHANGE IN ERECTILE FUNCTION SCORE BEFORE AND AFTER URETHROPLASTY IN PELVIC FRACTURE URETHRAL INJURIES (PFUIS) PATIENTS

Authors :

Dr.Shezad, Dr.Mehran, Dr.Sunil Kumar, Dr.Imran Malik, Dr.Ahmed ullah, Dr.Farag Mohsen Saleh Abo Ali, Dr.Mohsin Mustafa Memon, Prof.Manzoor Husain

Abstract :

Introduction: Pelvic fracture urethral injuries (PFUIs) often result from high velocity injuries that are associated with disruption of the pelvic ring. Delayed open urethroplasty is a highly effective and durable approach for treating PFUIs. One of the more concerning complications of urethroplasty is postoperative ED. Erectile dysfunction (ED) is thought to be vasculogenic, neurogenic, corporal and psychogenic in etiology and resulting from fracture itself. Pelvic fracture with or without urethral injury have been linked to ED with an incidence varying from 18% to 72%. Objective: To determine the mean change in erectile function score before and after urethroplasty in pelvic fracture urethral injuries (PFUIs) patients. Study Design : Quasi experimental Study. Setting: Department of Urology, Sindh Institute of Urology and Transplantation, Karachi. Duration of Study: 24-Aug-2019 to 23-Feb-2020. Patients and Methods: A total number of 66 patients with diagnosis of PFUIs having age 20 to 60 years were included in this study. Anastomotic urethroplasty was done in all patients by one consultant urologist. Erectile function was evaluated via a translated and culturally adapted Urdu version of the International Index of Erectile Function (IIEF – 5) questionnaire. For each patient the questionnaire was filled twice before surgery and 3 months after surgery based on their sexual activity condition. Overall IIEF score before and after urethroplasty was calculated to see mean change in IIEF score.Results: Mean age of patients was 41.13±11.10 years. Mean body mass index (BMI) of patients was 24.41±3.52 Kg/m2. Mean duration of symptoms of PFUIs was 8.74±3.5 months. Mean duration of marriage was 16.96±8.86 years. On comparison of before surgery and after surgery IIEF score, before surgery IIEF score was 20.10±3.47 and after surgery was 19.80±3.35 (p-value 0.119). Mean IIEF score was 19.82±3.33 in patients having age ≤40 years versus 19.78±3.42 in patients having age >40 years (p-value 0.04). Conclusion: There is no effect of surgery on erectile function in patients of post-fracture urethral injuries (PFUIs). We found significant effect of age on erectile function after surgery in these patients. Keywords: Pelvic fracture urethral injuries (PFUIs), urethroplasty, erectile dysfunction,

Cite This Article:

Please cite this article in press Shezad et al., To Determine The Mean Change In Erectile Function Score Before And After Urethroplasty In Pelvic Fracture Urethral Injuries (PFUIS) Patients.., Indo Am. J. P. Sci, 2021; 08(07).

Number of Downloads : 10

References:

1. Gomez RG, Mundy T, Dubey D, El-Kassaby AW, Firdaoessaleh, Kodama R.
2. et al. SIU/ICUD consultation on urethral strictures: pelvic fracture urethral injuries. Urology. 2014;83(3 Suppl):S48-S58.
3. Johnsen NV, Kaufman MR, Dmochowski RR, Milam DF. Erectile dysfunction following pelvic fracture urethral injury. Sexual Med Rev. 2018;6(1):114-23.
4. Osman NI, Mangera A, Inman RD, Chapple CR. Delayed repair of pelvic fracture urethral injuries: Preoperative decision-making. Arab JUrol. 2015;13(3):217-20.
5. Sangkum P, Levy J, Yafi FA, Hellstrom WJ. Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes. Andrology. 2015;3(3):443-9.
6. Koraitim MM. Predictors of erectile dysfunction post pelvic fracture urethral injuries: a multivariate analysis. Urology. 2013;81(5):1081-5.
7. El-Assmy A, Harraz AM, Benhassan M, Nabeeh A, Ibrahiem EH. Erectile
8. function after anastomotic urethroplasty for pelvic fracture urethral injuries. Int J Impotence Res. 2016;28(4):1-4.
9. Anger JT, Sherman ND, Dielubanza E, Webster GD. Erectile function after posterior urethroplasty for pelvic fracture urethral distraction defect injuries.
10. BJU int. 2009;104(8):1126-9.
11. Blaschko SD, Sanford MT, Schlomer BJ, Alwaal A, Yang G, Villalta JD, et al. The incidence of erectile dysfunction after pelvic fracture urethral injury: a systematic review and meta-analysis. Arab J Urol. 2015;13(1):68-74.
12. Hosseini J, SoleimanzadehArdebili F, Fadavi B, Haghighatkhah H.Effects of Anastomotic Posterior Urethroplasty (Simple or Complex) on Erectile Function: a Prospective Study. Urol J. 2018;15(2):33-37.
13. Xie H, Xu YM, Xu XL, Sa YL, Wu DL, Zhang XC. Evaluation of erectile functionafterurethral reconstruction: a prospective study. Asian J
14. Androl. 2009;11(2):209-14.
15. Gómez RG, Mundy T, Dubey D, El-Kassaby AW, Kodama R, Santucci R.
16. SIU/ICUD consultation on urethral strictures: pelvic fracture urethral injuries.
17. Urology. 2014;83(3):S48-58. Erickson BA, Granieri MA, Meeks JJ, Cashy JP, Gonzalez CM. Prospective analysis of erectile dysfunction after anterior urethroplasty: incidence and recovery of function. J Urol. 2010;183(2):657-61.
18. Kessler TM, Fisch M, Heitz M, Olianas R, Schreiter F. Patient satisfaction with the outcome of surgery for urethral stricture. J Urol. 2002;167(6):2507-11.
19. El-Assmy A, Benhassan M, Harraz AM, Nabeeh A, El Housseiny II. Ejaculatory function after anastomotic urethroplasty for pelvic fracture urethral injuries. Int Urol Nephrol. 2015;47(3):497-501.
20. Koraitim MM. Predictors of erectile dysfunction post pelvic fracture urethral injuries: a multivariate analysis. Urology. 2013;81(5):1081-5.
21. Copuroglu C, Yilmaz B, Yilmaz S, Ozcan M, Ciftdemir M, Copuroglu E. Sexual dysfunction of male, after pelvic fracture. Eur J Trauma Emerg Surg. 2017;43(1):59-63.
22. Dogra PN, Singh P, Nayyar R, Yadav S. Sexual Dysfunction after
23. urethroplasty. Urol Clin. 2017;44(1):49-56.
24. Sachin D, Chikka MSM, Vilvapathy SK, Chandrashekar SR, Ramaiah K. Incidence of de novo erectile dysfunction after urethroplasty: a prospective observational study. World J Mens Health. 2017;35(2):94-99.
25. Xie H, Xu YM, Xu XL, Sa YL, Wu DL, Zhang XC. Evaluation of erectile function after urethral reconstruction: a prospective study. Asian J Androl. 2009;11(2):209-14.