Pain, Pattern and Polytrauma – Predictors of Sexual Dysfunction in Pelvic Fractures: A Retrospective Multicenter Analysis

Objectives: In the local and cultural setting of high trauma rates and a reserved outlook on sexual function, this study examines the incidence and underlying factors of sexual dysfunction (SD) following pelvic fractures.Methods: A Multi-center retrospective cohort analysis performed in two general hospitals and one tertiary orthopedic center with collection between ۲۰۱۷ and ۲۰۱۹. Consecutive patients with pelvic fractures between January ۲۰۱۷ and February ۲۰۱۹ were followed up at ۱۸-۲۴ months to screen for new-onset SD using the International Index of Erectile Function-۵ (IIEF-۵) and Female-Sexual-Function-Index-۶ (FSFI-۶). Additional variables include age, sex, Young-Burgess classification, urogenital injury, injury severity score, persisting pain, sacroiliac disruption, intervention and if sexual health was discussed or patient referred for sexual healthcare.Results: One-hundred and sixty-five patients (n = ۱۶۵) were included, (۸۳%) male, (۱۶%) female with a mean age of ۳۵.۱ years (Range ۱۸-۵۵). Fracture patterns included lateral compression (LC) (۵۱.۵%), anteroposterior compression (APC) (۲۷.۷%), and vertical shear (VS) (۲۰.۶%). The urogenital injury occurred in ۱۰.۳%. The mean IIEF-۵ and FSFI-۶ scores were ۲۰.۸ and ۲۴.۷ in males and females, respectively. A total of ۴۰ males (۲۹%) scored below the ۲۱ cut-off scores for SD, while only one female (۳.۷%) scored below the corresponding score of ۱۹. Of all participants reporting sexual dysfunction, ۵۶% discussed sexual health with their providers, while ۴۶% of these patients were referred for further management. Significant predictive factors for SD using a multivariate logistic regression model include increasing age (OR-۱.۰۹۳, p = ۰.۰۰۶), APC III (OR ۸۸.۸۸۷, p = ۰.۰۰۶), VS (OR-۱۵.۶۰۷, p = ۰.۰۲۰), persisting pain (OR ۳.۶۰۰, p = ۰.۰۲۱) and increasing injury severity score (OR ۱.۱۸۴, p <۰.۰۰۱).Conclusion: SD is common among pelvic fractures, and risk factors include APC or VS type fractures, increasing age, increasing injury severity score, and persisting pain. Providers should ensure patients are screened for SD and referred appropriately as patients may not willingly disclose underlying symptoms. Level of evidence: III

کلیدواژه ها:

outcomes ، Pelvic Fractures ، Sexual health ، Trauma ، Urogenital Injury