title: Ejaculatory profiles and fertility in men after posterior urethroplasty for pelvic fracture-urethral distraction defect injuries.
abstract: OBJECTIVE
  In men who sustain a pelvic fracture-urethral distraction defect (PFUDD) injury, repairing the urethra involves a complicated urethral anastomosis located posteriorly at the junction of the membranous and prostatic urethra. In this study we performed a post- operative semen analysis and questionnaire study to determine the effect of PFUDD injuries and PFUDD repair on ejaculatory function and fertility in these men.
  
  
  METHODS
  With institutional review board approval, patients who had PFUDD repairs by one surgeon from 1990 to 2004 were identified from a database. Patients were contacted and given a questionnaire eliciting details about their ejaculatory function and history of fertility. Those interested in future paternity were asked to provide semen for analysis.
  
  
  RESULTS
  In all, 32 men were contacted; all claimed to have antegrade ejaculation, although five reported having a lower ejaculatory volume than before their injury, and one claimed that his ejaculate was delayed. We assessed fertility in 19 men, six of whom had either infertility or abnormal semen analyses.
  
  
  CONCLUSIONS
  All men in the present series who had PFUDD injuries repaired had antegrade ejaculation. Although six of 19 had either infertility or an abnormal semen analysis, it appears that the risk of damage to the ejaculatory ducts from either a PFUDD or the subsequent urethral reconstruction is low. However, other associated injuries at the time of the pelvic fracture might place these men at greater risk of infertility.
authors.affiliation: Department of Urology, University of California, Los Angeles, CA 90404, USA. janger@mednet.ucla.edu
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Anger
authors.forename: Neil D
authors.initials: ND
authors.lastname: Sherman
authors.forename: George D
authors.initials: GD
authors.lastname: Webster
mesh_terms: D004542:Ejaculation / Q000502:physiology*; D004543:Ejaculatory Ducts / Q000293:injuries; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D012307:Risk Factors; D012661:Semen / Q000737:chemistry; D011795:Surveys and Questionnaires; D014521:Urethra / Q000293:injuries*; D014525:Urethral Stricture / Q000209:etiology; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*; D014947:Wounds and Injuries / Q000150:complications