A correlation study of ischiocavernosus muscle injury with different types of pelvic fractures and erectile dysfunction after pelvic fracture

Abstract

Objective: To explore the correlation between ischiocavernosus muscle injury (ICMI) with different types of pelvic fractures and erectile dysfunction (ED) after pelvic fracture. Design: Retrospective analysis of a prospective database. Setting: The study was carried out at the affiliated hospital of Zunyi Medical University. Patients/participants: A total of 776 male patients with pelvic fracture, aged 18 to 67 years, were recruited for this study by retrospective analysis, and based on the diagnosis of ED and the presence of ICMI, the participants were divided into ED and non-ED groups as well as ICMI and non-ICMI groups. Intervention: No. Main outcome measurements: ICMI, the type of pelvic fracture, International Index of Erectile Function-5 scores. Computed tomography/magnetic resonance imaging scans, electromyography (motor unit potential) was used to diagnose ICMI. Results: The International Index of Erectile Function-5 score was 19.7 ± 5.9. The incidence of ED was 27.3%, the duration time of ED was 30 ± 23 months, and the incidence of reversible ED was 39.6% and of irreversible ED was 60.4%. The incidence of ICMI was 29.4%, among which the incidence of unilateral injury was 57.9%, and the incidence of bilateral injury was 42.1%. Among all pelvic fractures, the incidence of pubic ramus fracture was 88.1%. Bilateral pubic ramus fractures, bilateral fractures of the ischial ramus, and ICMI were independent risk factors for ED after pelvic fracture. Bilateral pubic ramus fractures and pubic symphysis separation were independent risk factors for ICMI. Unilateral ICMI was an independent risk factor for reversible ED, while bilateral ICMI was an independent risk factor for irreversible ED. Conclusions: ICMI is associated with ED and may be a cause for ED, while pubic ramus fracture, ischial ramus fracture, and pubic symphysis separation may be the main causes of ICMI. Unilateral ICMI may be the main risk factor for transient ED, and bilateral ICMI may be the main risk factor for permanent ED.

Effects of unilateral/bilateral amputation of the ischiocavernosus muscle in male rats on erectile function and conception

“…One view was that ICM plays only an auxiliary role in the mechanism of penile erection [1][2][3][4]. However, another view, including the study authors', was that ICM plays an important role in the mechanism of penile erection [5,6,[14][15][16][17][18]. The results of this study also support the latter view.…”

“…This method is not suitable for male or female rats with internal reproductive organ problems. Furthermore, the impact of species differences on the application of our findings to humans requires clarification [6,[23][24][25][26][27][28][29].…”

“…According to the traditional view, the contraction of the ICM acts as a lever on the upturned penis and plays an auxiliary role in penile erection [4]. However, our previous studies reported on the role of ICM contractions in preventing blood backflow into the corpus cavernosum and maintaining a stiff erection [5,6]. Moreover, findings from the series of our basic studies on the ICM suggested that unilateral amputation of the ICM in a male rat could cause transient erectile dysfunction (ED), thus resulting in delayed conception in the paired female rat.…”

“…In addition, in clinical practice, we performed computed tomography (CT)/magnetic resonance imaging (MRI)/electromyography (EMG) for patients with pelvic fracture with ED as a complication and found objective evidence of ICM injury [6]. Our previous studies provided novel ideas for the clinical diagnosis and treatment of ICM injury and ED following a pelvic fracture [5,6].…”