IMPOTENCE FOLLOWING PELVIC FRACTURE URETHRAL INJURY - INCIDENCE, ETIOLOGY AND MANAGEMENT

被引:70
作者
MARK, SD
KEANE, TE
VANDEMARK, RM
WEBSTER, GD
机构
[1] DUKE UNIV, MED CTR, DEPT SURG, DIV UROL, DURHAM, NC 27710 USA
[2] DUKE UNIV, MED CTR, DEPT RADIOL, DURHAM, NC USA
来源
BRITISH JOURNAL OF UROLOGY | 1995年 / 75卷 / 01期
关键词
IMPOTENCE; PELVIC FRACTURE URETHRAL INJURY; NEUROGENIC; CAVERNOSAL NERVES;
D O I
10.1111/j.1464-410X.1995.tb07234.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 [临床医学]; 100201 [内科学];
摘要
Objective To evaluate the potency status of patients undergoing delayed perineal repair following a pelvic fracture urethral injury to determine the incidence and aetiology of impotence. Patients and methods Long-term potency (>6 months post-operatively) was subjectively evaluated in 92 patients and correlated with their pre-operative and intra-operative findings. The management of their impotence was also reviewed. Thirty original pelvic radiographs were assessed independently to determine if the pattern of bony injury was associated with the development of impotence. Results Fifty-seven patients (62%) remained impotent in the long term with a median follow-up of 48 months (range 12-128) and the operation did not render any potent patient impotent. Self-injection with vasoactive agents was successful in 24 of 27 (89%), suggesting a neurogenic aetiology in the majority. Bilateral pubic rami fracture was also associated with a high incidence of impotence. Conclusion Disruption of the cavernosal nerves lateral to the prostatomembranous urethra behind the symphysis pubis is the most likely cause of impotence in this injury.
引用
收藏
页码:62 / 64
页数:3
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