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Blaschko SD, Sanford MT, Schlomer BJ, et al. The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis. Arab J Urol. 2014;13(1):68-74doi: 10.1016/j.aju.2014.09.004.
Blaschko, S. D., Sanford, M. T., Schlomer, B. J., Alwaal, A., Yang, G., Villalta, J. D., Wessells, H., McAninch, J. W., & Breyer, B. N. (2015). The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis. Arab journal of urology, 13(1), 68-74. https://doi.org/10.1016/j.aju.2014.09.004
Blaschko, Sarah D, et al. "The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis." Arab journal of urology vol. 13,1 (2015): 68-74. doi: https://doi.org/10.1016/j.aju.2014.09.004
Blaschko SD, Sanford MT, Schlomer BJ, Alwaal A, Yang G, Villalta JD, Wessells H, McAninch JW, Breyer BN. The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis. Arab J Urol. 2015 Mar;13(1):68-74. doi: 10.1016/j.aju.2014.09.004. Epub 2014 Oct 16. PMID: 26019983; PMCID: PMC4435659.
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Arab J Urol. 2015 Mar;13(1):68-74. doi: 10.1016/j.aju.2014.09.004. Epub 2014 Oct 16.

The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis.

Arab journal of urology

Sarah D Blaschko, Melissa T Sanford, Bruce J Schlomer, Amjad Alwaal, Glen Yang, Jacqueline D Villalta, Hunter Wessells, Jack W McAninch, Benjamin N Breyer

Affiliations

  1. Department of Urology, University of California, San Francisco, CA, USA.
  2. Department of Urology, University of Washington, Seattle, WA, USA.

PMID: 26019983 PMCID: PMC4435659 DOI: 10.1016/j.aju.2014.09.004

Abstract

BACKGROUND: Pelvic fracture urethral injury (PFUI) is associated with a high risk of erectile dysfunction (ED). The effect of the type of posterior urethral disruption repair on erectile function has not been clearly established. We systematically reviewed and conducted a meta-analysis of the proportion of patients with ED at (i) baseline after pelvic fracture with PFUI, (ii) after immediate primary realignment, and (iii) after delayed urethroplasty.

METHODS: Using search terms for primary realignment or urethroplasty and urethral disruption, we systematically reviewed PubMed and EMBASE. A meta-analysis of the proportion of patients with ED was conducted assuming a random-effects model.

RESULTS: Of 734 articles found, 24 met the inclusion criteria. The estimate of the proportion (95% confidence interval) of patients with ED after (i) PFUI was 34 (25-45)%, after (ii) immediate primary realignment was 16 (8-26)%, and after (iii) delayed urethroplasty was an additional 3 (2-5)% more than the 34% after pelvic fracture in this cohort.

CONCLUSIONS: After pelvic fracture, 34% of patients had ED. After primary endoscopic alignment, patients had a lower reported rate of ED (16%). Delayed urethroplasty conferred an additional 3% risk above the 34% associated with PFUI alone, with 37% of patients having de novo ED. The difference in de novo ED after primary endoscopic alignment vs. delayed urethroplasty is probably due to reporting differences in ED and/or patients with less severe injury undergoing primary realignment.

Keywords: ED, erectile dysfunction; Erectile dysfunction; IIEF, International Index of Erectile Function; Meta-analysis; PFUI, pelvic fracture urethral injury; Pelvic fracture; Systematic review; Urethral disruption

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