Effect of Trauma and Pelvic Fracture on Female Genitourinary, Sexual, and Reproductive Function

Copeland, Carol E.; Bosse, Michael J.; McCarthy, Melissa L.; MacKenzie, Ellen J.; Guzinski, G; Hash, Clare; Burgess, Andrew R.

doi:10.1097/00005131-199702000-00001

Cited by 113 publications

(97 citation statements)

References 31 publications

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“…Comparing reduction quality, patients with [ 5 mm persistent displacement had more difficulty with sexual intercourse at the 6-month interval. This is consistent with previous findings [6]. No other correlation with any functional outcome measurement or return to work was observed.…”

Section: Discussionsupporting

confidence: 93%

Persistent Impairment After Surgically Treated Lateral Compression Pelvic Injury

Hoffmann¹,

Jones

Sietsema

2012

Clinical Orthopaedics &Amp; Related Research

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Background Recently, fixation of lateral compression (LC) pelvic fractures has been advocated to improve patient comfort and to allow earlier mobilization without loss of reduction, thus minimizing adverse systemic effects. However, the degree of acceptable deformity and persistence of disability are unclear. Questions/purposes We determined if (1) injury pattern; (2) demographics; (3) final posterior displacement; (4) L5/ S1 involvement; (5) associated injuries; and (6) time influence outcome measurements, sexual dysfunction, and pain.

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Section: Discussionsupporting

confidence: 93%

Persistent Impairment After Surgically Treated Lateral Compression Pelvic Injury

Hoffmann¹,

Jones

Sietsema

2012

Clinical Orthopaedics &Amp; Related Research

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“…These findings are similar to previous studies (Table 10) reporting rates of impotence of 11% to 30% in males [18,20,24,25,34], with higher rates in studies considering only patients with urethral rupture [2,13,15,18,26,39]. Reported rates of dyspareunia range from 2% [34] to 43% [11] in females after pelvic injury (Table 11). A study of young women after pelvic fracture reported 45% feeling less sexually attractive and 39% experiencing a decrease in sexual pleasure [27].…”

Section: Discussionsupporting

confidence: 90%

“…These findings are supported by a previous German study [28] using the Tile classification [40], which reported higher rates of sexual dysfunction in Type B1 than B2 fractures and in Type C than B2 injuries, as well as other studies showing greater instability associated with more sexual complaints and less recovery [16,28,29,34]. However, there are conflicting reports, with other studies finding no apparent relationship of pelvic fracture type and sexual dysfunction in males [25,31] or females [3,9,11]. In contrast, men with sacroiliac fractures and women with diastasis of the pubis were reportedly at higher risk of sexual dysfunction and incontinence [43], whereas women with residually displaced pubic rami fractures experienced higher rates of urinary complaints and of dyspareunia than those without displacement [11].…”

Section: Discussionsupporting

confidence: 73%

“…However, there are conflicting reports, with other studies finding no apparent relationship of pelvic fracture type and sexual dysfunction in males [25,31] or females [3,9,11]. In contrast, men with sacroiliac fractures and women with diastasis of the pubis were reportedly at higher risk of sexual dysfunction and incontinence [43], whereas women with residually displaced pubic rami fractures experienced higher rates of urinary complaints and of dyspareunia than those without displacement [11]. Our data suggest neither sex nor presence of GUI was predictive of either sexual (Table 8) or urinary dysfunction (Table 9) despite observing higher incidences in patients with GUI than those with no GUI.…”

Section: Discussionmentioning

confidence: 99%

“…Urinary symptoms and sexual dysfunction such as dyspareunia, painful orgasms, anorgasmia, and reduced sex drive or pleasure have been reported in the absence of GUI with pelvic fractures [19,41,43]. Higher rates of urinary symptoms (33% versus 14%) and dyspareunia (43% versus 25%) were reported in females with residually displaced pelvic fractures than with nondisplaced fractures [11].…”

Section: Introductionmentioning

confidence: 99%

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High Rates of Sexual and Urinary Dysfunction After Surgically Treated Displaced Pelvic Ring Injuries

Odutola

Sabri

Halliday

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Pelvic ring injuries may be associated with genitourinary injury (GUI) and result in urinary or sexual dysfunction. Questions/purposes 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. urinary OR, 4.6; 95% CI,). 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. Level of Evidence Level III, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Fertility and reproductive outcomes following high‐energy pelvic fractures: A systematic review and meta‐analysis

Kastora

Eley

Kounidas

et al. 2023

Intl J Gynecology & Obste

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Background There is a need to decipher the effect of pelvic fractures (PFs) upon female fertility and live birth rate, as data including treatment regimens in large, unselected populations remain scarce. Objectives To assess the effect of high energy PFs upon female fertility and live birth rate. Search strategy Literature search for relevant studies was performed up to March 2022 in five databases: Embase, MEDLINE, CAB Abstracts, ClinicalTrials.gov, and Google Scholar. Selection criteria Retrospective studies assessing live birth, infertility, and dyspareunia rates following PFs. Data collection and analysis Data were extracted from studies independently by two authors. The quality of the included studies was assessed using the Newcastle‐Ottawa Scale (NOS) for observational studies. Main results A total of 763 female patients of median age 27.8 years (95% CI 22–38 years) were included with median follow up of 5 years. Among PF patients, infertility hazard ratio (HR) 1.18 (95% CI 0.76–1.84, P = 0.47; I2 = 18%) and dyspareunia HR 0.60 (95% CI 0.34–1.08, P = 0.09; I2 = 66%), did not significantly differ from the age‐matched literature‐reported rates among non‐PF patients. Conclusions No significant differences of live birth, infertility, and dyspareunia rates across patients with PFs were found compared with non‐PF counterparts.

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Effect of Trauma and Pelvic Fracture on Female Genitourinary, Sexual, and Reproductive Function

Abstract: We found that pelvic trauma negatively affected the genitourinary and reproductive function of female patients. The increased rate of cesarean section in women after pelvic trauma may be multifactorial in origin and warrants further investigation.

Cited by 113 publications

References 31 publications

Persistent Impairment After Surgically Treated Lateral Compression Pelvic Injury

Persistent Impairment After Surgically Treated Lateral Compression Pelvic Injury

High Rates of Sexual and Urinary Dysfunction After Surgically Treated Displaced Pelvic Ring Injuries

Fertility and reproductive outcomes following high‐energy pelvic fractures: A systematic review and meta‐analysis

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