Preliminary data on the neurophysiological evaluation of male sexual dysfunction in patients with pelvic ring fractures: a multicenter retrospective study

G. Rovere, A. Fusco, A. Smakaj, D. De Mauro, R. De Vitis, L. Padua, L. Meccariello, A. Fidanza, R. Erasmo, M. Peresson, G. Noia, G. Maccagnano, G. Maccauro, F. Liuzza

Department of Aging, Neurological, Orthopaedic and Head-Neck Sciences, UOC Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. francesco.liuzza@policlinicogemelli.it

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• Orthopedics

OBJECTIVE: Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations.

PATIENTS AND METHODS: Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile’s type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications.

RESULTS: A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients.

CONCLUSIONS: Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments.

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