title: High rates of sexual and urinary dysfunction after surgically treated displaced pelvic ring injuries.
abstract: BACKGROUND
  Pelvic ring injuries may be associated with genitourinary injury (GUI) and result in urinary or sexual dysfunction.
  
  
  OBJECTIVE
  We determined (1) incidence of new sexual and urinary dysfunction after surgically treated pelvic ring injuries, (2) association of sexual or urinary dysfunction to fracture type and GUI, and (3) incidence and association between new sexual and urinary dysfunction in male and female patients without GUI.
  
  
  METHODS
  We retrospectively studied 151 patients by postal questionnaire after pelvic reconstruction. Presence, type, and severity of new sexual dysfunction and urinary dysfunction were related to GUI and type of pelvic fracture using the Young and Burgess classification. Minimum followup was 1 year (median, 5 years; range, 1-12 years).
  
  
  RESULTS
  New sexual dysfunction occurred in 61 of 143 (43%) and urinary dysfunction in 61 of 150 (41%) responding patients. Neither new sexual nor urinary dysfunction was associated with sex or GUI. In patients with no GUI, new sexual dysfunction was associated with chronologic age (odds ratio [OR], 1.04/year; 95% CI, 1.01-1.07) and pelvic fracture type. Lateral compression injury was less likely to result in new sexual or urinary dysfunction compared with AP type (sexual OR, 1.73; 95% CI, 0.67-4.47; urinary OR, 2.97; 95% CI, 1.15-7.66) and vertical shear type (sexual OR, 2.60; 95% CI, 1.02-6.64; urinary OR, 4.6; 95% CI, 1.81-11.73).
  
  
  CONCLUSIONS
  Our data suggest new sexual and urinary dysfunction occur at relatively high rates after pelvic fracture in patients with or without GUI. We recommend early assessment and referral for specialist treatment.
  
  
  METHODS
  Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Pelvic and Acetabular Reconstruction Unit, Frenchay Hospital, North Bristol NHS Trust, Bristol, UK.
authors.forename: Adekoyejo A
authors.initials: AA
authors.lastname: Odutola
authors.forename: Omar
authors.initials: O
authors.lastname: Sabri
authors.forename: Ruth
authors.initials: R
authors.lastname: Halliday
authors.forename: Timothy J S
authors.initials: TJ
authors.lastname: Chesser
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017760:Bone Malalignment / Q000150:complications / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D050815:Fractures, Compression / Q000150:complications / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000453:epidemiology; D010384:Pelvic Bones / Q000293:injuries*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014555:Urination Disorders / Q000209:etiology*; D014566:Urogenital System / Q000293:injuries; D055815:Young Adult