Sexual function impairment after high energy pelvic fractures: evidence today

Purpose: Sexual dysfunction has been associated with pelvic fractures, especially in patients with concomitant urethral injuries. A critical review of the existing literature was performed focusing on the reported definitions of sexual dysfunction, its reported incidence, the presence of related risk factors, the methods of assessing sexual function, the timing of this assessment and its management.

Materials and methods: The PubMed® search engine was used in July 2010 to retrieve articles using the terms "pelvic fracture" and "sexual function" in their title or abstract, published in the English language, from 1989 onward. The references of the selected publications were also evaluated for potential relevant studies according to set selection criteria.

Results: Based on 23 original articles the data of 1,462 patients, with a mean age of 37.7 years (range 15 to 92), were analyzed. The overall mean reported incidence of sexual dysfunction was 35.9% in men and 39.6% in women. Various methods were applied for the evaluation of sexual dysfunction, and were questionnaire based in 22 of the 23 studies. Important factors associated with sexual dysfunction were age, pelvic fracture pattern, presence of urogenital injury and injury severity score.

Conclusions: Male and female patients were equally affected by sexual dysfunction following pelvic blunt trauma. Limited consensus exists in the definition of sexual dysfunction, the methods and timing of assessment, as well as its management. The existing literature offers limited evidence regarding sexual dysfunction in females, as for both genders in the absence of urogenital initial trauma.