Pain, Pattern and Polytrauma – Predictors of Sexual Dysfunction in Pelvic Fractures: A Retrospective Multicenter Analysis | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 7، دوره 11، شماره 4، تیر 2023، صفحه 263-269 اصل مقاله (683.05 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2022.57958.2869 | ||
| نویسندگان | ||
| Ali Lari* 1؛ Ali Jarragh2؛ Mohammad Alherz3؛ Abdullah AlNouria1؛ Mohammed Qasem1؛ Alia F. Khaja1؛ Owayed Almutairi4 | ||
| 1Alrazi Orthopedic Hospital, Alsabah medical region, Kuwait | ||
| 2Jaber Alahmed Alsabah Hospital, South Surra, Kuwait | ||
| 3Farwaniya Hospital, Farwaniya Governorate, Kuwait | ||
| 4Alsalam International Hospital, Bneid Al Gar, Kuwait | ||
| چکیده | ||
| 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 2017 and 2019. Consecutive patients with pelvic fractures between January 2017 and February 2019 were followed up at 18-24 months to screen for new-onset SD using the International Index of Erectile Function-5 (IIEF-5) and Female-Sexual-Function-Index-6 (FSFI-6). 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 = 165) were included, (83%) male, (16%) female with a mean age of 35.1 years (Range 18-55). Fracture patterns included lateral compression (LC) (51.5%), anteroposterior compression (APC) (27.7%), and vertical shear (VS) (20.6%). The urogenital injury occurred in 10.3%. The mean IIEF-5 and FSFI-6 scores were 20.8 and 24.7 in males and females, respectively. A total of 40 males (29%) scored below the 21 cut-off scores for SD, while only one female (3.7%) scored below the corresponding score of 19. Of all participants reporting sexual dysfunction, 56% discussed sexual health with their providers, while 46% of these patients were referred for further management. Significant predictive factors for SD using a multivariate logistic regression model include increasing age (OR-1.093, p = 0.006), APC III (OR 88.887, p = 0.006), VS (OR-15.607, p = 0.020), persisting pain (OR 3.600, p = 0.021) and increasing injury severity score (OR 1.184, p <0.001). 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 | ||
| کلیدواژهها | ||
| Outcomes؛ Pelvic Fractures؛ Sexual Health؛ Trauma؛ Urogenital Injury | ||
| مراجع | ||
|
1. Giannoudis P V, Grotz MRW, Tzioupis C, et al. Prevalence of Pelvic Fractures, Associated Injuries, and Mortality: The United Kingdom Perspective. J Trauma. 2007; 63(4):875–83. http://dx.doi.org/10.1097/01.ta.0000242259.67486.15 2. Verbeek DO, Ponsen KJ, Fiocco M, Amodio S, Leenen LPH, Goslings JC. Pelvic fractures in the Netherlands: epidemiology, characteristics and risk factors for in-hospital mortality in the older and younger population. Eur J Orthop Surg Traumatol. 2017; 28(2):197–205. http://dx.doi.org/10.1007/s00590- 017-2044-3 3. Pohlemann T, Stengel D, Tosounidis G, et al. Survival trends and predictors of mortality in severe pelvic trauma: Estimates from the German Pelvic Trauma Registry Initiative. Injury. 2011; 42(10):997–1002. http://dx.doi.org/10.1016/j.injury.2011.03.053 4. Odutola AA, Sabri O, Halliday R, Chesser TJS, Ward AJ. High rates of sexual and urinary dysfunction after surgically treated displaced pelvic ring injuries. Clin Orthop Relat Res. 2012; 470(8):2173–84. doi: 10.1007/s11999-012-2257-z. 5. Demetriades D, Karaiskakis M, Toutouzas K, Alo K, Velmahos G, Chan L. Pelvic fractures: epidemiology and predictors of associated abdominal injuries and outcomes. J Am Coll Surg. 2002; 195(1):1–10. http://dx.doi.org/10.1016/s1072-7515 (02)01197-3 6. Bjurlin MA, Fantus RJ, Mellett MM, Goble SM. Genitourinary Injuries in Pelvic Fracture Morbidity and Mortality Using the National Trauma Data Bank. J Trauma Inj Infect Crit Care. 2009; 67(5):1033–9. http://dx.doi.org/10.1097/ta.0b013e3181bb8d6c 7. Velazquez N, Fantus RJ, Fantus RJ, Kingsley S, Bjurlin MA. Blunt trauma pelvic fracture-associated genitourinary and concomitant lower gastrointestinal injury: incidence, morbidity, and mortality. World J Urol. 2019; 38(1):231–8. http://dx.doi.org/10.1007/s00345-019-02725-7 8. Guan Y, Wendong S, Zhao S, et al. The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures. Int Braz J Urol. 2015; 41(5):959–66. doi: 10.1590/S1677-5538.IBJU.2014.0170. 9. Johnsen N V, Lang J, Wessells H, Vavilala MS, Rivara FP, Hagedorn JC. Barriers to Care of Sexual Health Concerns in Men Following Traumatic Pelvic Fractures. J Sex Med. 2019; 16(10):1557–66. http://dx.doi.org/10.1016/j.jsxm.2019.07.014 10. Harvey-Kelly KF, Kanakaris NK, Eardley I, Giannoudis P V. Sexual Function Impairment after High Energy Pelvic Fractures: Evidence Today. J Urol. 2011; 185(6):2027–34. http://dx.doi.org/10.1016/j.juro.2011.01.076 11. Kennedy SH, Rizvi S. Sexual Dysfunction, Depression, and the Impact of Antidepressants. J Clin Psychopharmacol. 2009; 29(2):157–64. http://dx.doi.org/10.1097/jcp.0b013e31819c76e9 12. Wright JL, Nathens AB, Rivara FP, MacKenzie EJ, Wessells H. Specific Fracture Configurations Predict Sexual and Excretory Dysfunction in Men and Women 1 Year after Pelvic Fracture. J Urol. 2006; 176(4):1540–5. http://dx.doi.org/10.1016/j.juro.2006.06.044 13. Burgess AR, Eastridge BJ, Young JWR, et al. Pelvic Ring Disruptions: effective classification system and treatment protocols. J Trauma Inj Infect Crit Care. 1990; 30(7):848–56. http://dx.doi.org/10.1097/00005373-199007000-00015 14. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49(6):822–30. http://dx.doi.org/10.1016/s0090-4295 (97)00238-0 15. Isidori AM, Pozza C, Esposito K, et al. Development and Validation of a 6-Item Version of the Female Sexual Function Index (FSFI) as a Diagnostic Tool for Female Sexual Dysfunction. J Sex Med. 2010; 7(3):1139–46. http://dx.doi.org/10.1111/j.1743-6109.2009.01635.x 16. Shamloul R, Ghanem H, Abou-zeid A. Validity of the Arabic version of the sexual health inventory for men among Egyptians. Int J Impot Res. 2004; 16(5):452–5. http://dx.doi.org/10.1038/sj.ijir.3901248 17. Anis T, Gheit SA, Saied HS, Al-kherbash SA. American Psychological Association. APA PsycTESTS Dataset.Female Sexual Function Index—Arabic Version. Available at: https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft3171 7-000. Accessed, 2011. 18. Martin MP, Rojas D, Dean CS, et al. Psychological outcomes affect functional outcomes in patients with severe pelvic ring fractures. Injury. 2021; 52(10):2750-2753. http://dx.doi.org/10.1016/j.injury.2020.02.071 19. Duramaz A, Ilter MH, Yıldız Ş, Edipoğlu E, İpek C, Bilgili MG. The relationship between injury mechanism and sexual dysfunction in surgically treated pelvic fractures. Eur J Trauma Emerg Surg. 2019; 46(4):807–16. http://dx.doi.org/10.1007/s00068-018-01067-0 20. Metze M, Tiemann AH, Josten C. Male Sexual Dysfunction after Pelvic Fracture. J Trauma Inj Infect Crit Care. 2007; 63(2):394–401. http://dx.doi.org/10.1097/01.ta.0000241145.02748.df 21. Kroupa J. [Definition of "polytrauma" and "polytraumatism"].Acta Chir Orthop Traumatol Cech. 1990; 57(4):347-60. 22. Kwan KSH, Roberts LJ, Swalm DM. Sexual dysfunction and chronic pain: the role of psychological variables and impact on quality of life. Eur J Pain. 2005; 9(6):643. http://dx.doi.org/10.1016/j.ejpain.2004.12.008 23. Walton A, Leinwand G, Raheem O, Hellstrom W, Brandes S, Benson C. Female Sexual Dysfunction After Pelvic Fracture: A Comprehensive Review of the Literature. J Sex Med.2021; 18(3):467-473. doi: 10.1016/j.jsxm.2020.12.014. 24. Patel DN, Fok CS, Webster GD, Anger JT. Female urethral injuries associated with pelvic fracture: a systematic review of the literature. BJU Int. 2017; 120(6):766-773. doi: 10.1111/bju.13989. | ||
|
آمار تعداد مشاهده مقاله: 366 تعداد دریافت فایل اصل مقاله: 365 |
||