title: The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures.
abstract: Erectile dysfunction (ED) is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5) questionnaire. Nocturnal penile tumescence (NPT) testing confirmed the occurrence of ED in 96 (80%) patients on whom penile duplex ultrasound and neurophysiological testing were further performed. Of these ED patients 29 (30%) were demonstrated only with vascular abnormality, 41 (42.7%) were detected only with neural abnormality, 26 (27.1%) revealed mixed abnormalities. Of the 55 patients (29+26) with vascular problems, 7 patients (12.7%) with abnormal arterial response to intracavernous injection of Bimix (15mg papaverine and 1mg phentolamine), 31 (56.4%) with corporal veno-occlusive dysfunction and 17 (30.9%) had both problems. Of the 67 (41+26) patients with abnormal neurophysiological outcomes, 51 (76.1%) with abnormal bulbocavernosus re?ex (BCR), 20 (29.9%) with pathological pudendal nerve evoked potentials (PDEPs) and 25 (37.3%) with abnormal posterior tibial somatosensory nerve evoked potentials (PTSSEPs). Our observation indicated that neurogenic factors are important for the generation of ED in patients with pelvic fracture; venous impotence is more common than arteriogenic ED.
authors.affiliation: ShanDong University, Jinan, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Guan
authors.affiliation: Department of Urology, the Second Hospital of ShanDong University, Jinan, China.
authors.forename: Sun
authors.initials: S
authors.lastname: Wendong
authors.affiliation: Department of Urology, the Second Hospital of ShanDong University, Jinan, China.
authors.forename: Shengtian
authors.initials: S
authors.lastname: Zhao
authors.affiliation: The Second Hospital of ShanDong University, Jinan, China.
authors.forename: Tongyan
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Urology, the Second Hospital of ShanDong University, Jinan, China.
authors.forename: Yuqiang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Urology, the Second Hospital of ShanDong University, Jinan, China.
authors.forename: Xiulin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Urology, the Second Hospital of ShanDong University, Jinan, China.
authors.forename: Mingzhen
authors.initials: M
authors.lastname: Yuan
mesh_terms: D000328:Adult; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D050723:Fractures, Bone / Q000150:complications* / Q000503:physiopathology*; D006728:Hormones / Q000097:blood; D006801:Humans; D018783:Impotence, Vasculogenic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D010410:Penile Erection / Q000502:physiology; D010413:Penis / Q000098:blood supply / Q000294:innervation; D012021:Reflex, Abnormal / Q000502:physiology; D057566:Self Report; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex; D014521:Urethra / Q000293:injuries / Q000503:physiopathology; D055815:Young Adult
chemical_list: D006728:Hormones