Quantifying Urinary and Sexual Dysfunction Following Pelvic Fracture.

To quantify the severity of urinary and sexual dysfunction, and to evaluate the relationship between urinary and sexual dysfunction, injury, and treatment factors in patients with pelvic fracture.
Prospective cohort study.
Level 1 trauma center.Patients/Participants: 113 patients with surgically treated pelvic fracture (65.5% OTA/AO 61B fractures; 7 open fractures; 74 men).
Surgical pelvic stabilization.
Short Form-36 Health Survey (SF-36) and International Consultation Incontinence Questionnaire (ICIQ) responses were collected at baseline, 6 months and 1, 2 and 5 years. Patients were scored on symptoms of voiding and incontinence, and filling (for women), to derive urinary function. Sexual function was scored as a single domain. Both genders reported urinary and sexual bothersome symptoms. Regression analysis was used to isolate the importance of predictive factors on urinary and sexual function, urinary and sexual bother, and their impact on quality of life.
Patients with pelvic fracture have significant urinary and sexual dysfunction, which is sustained or worsens over time. Male urinary function was predicted by Injury Severity Score (p=0.03) and 61C fracture (odds ratio (OR): 3.23, p=0.04). Female urinary function was predicted by urinary tract injury at admission (OR: 7.57, p=0.03). Neurologic injury and anterior fixation were identified as significant predictors for male sexual function and sexual bother, while urological injuries were important in predicting female urinary and sexual bother (p<0.01). Sexual function (p=0.02) and sexual bother (p<0.001) were important predictors of overall mental well-being in men.
Urinary and sexual dysfunction is prevalent and sustained in men and women, and do not follow the prolonged slow recovery trajectory seen in physical function. Male urinary and sexual dysfunction was closely tied to neurological injury, while female urinary and sexual dysfunction was predicted by presence of a urinary tract injury. Urinary and sexual dysfunction were important to overall mental well-being in men.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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