TO DETERMINE THE MEAN CHANGE IN ERECTILE FUNCTION SCORE BEFORE AND AFTER URETHROPLASTY IN PELVIC FRACTURE URETHRAL INJURIES (PFUIS) PATIENTS

Introduction: Pelvic fracture urethral injuries (PFUIs) often result from high velocity injuries that are associated with disruption of the pelvic ring. Delayed open urethroplasty is a highly effective and durable approach for treating PFUIs. One of the more concerning complications of urethroplasty is postoperative ED. Erectile dysfunction (ED) is thought to be vasculogenic, neurogenic, corporal and psychogenic in etiology and resulting from fracture itself. Pelvic fracture with or without urethral injury have been linked to ED with an incidence varying from 18% to 72%. Objective: To determine the mean change in erectile function score before and after urethroplasty in pelvic fracture urethral injuries (PFUIs) patients. Study Design : Quasi experimental Study. Setting: Department of Urology, Sindh Institute of Urology and Transplantation, Karachi. Duration of Study: 24-Aug-2019 to 23-Feb-2020.  Patients and Methods: A total number of 66 patients with diagnosis of PFUIs having age 20 to 60 years were included in this study. Anastomotic urethroplasty was done in all patients by one consultant urologist. Erectile function was evaluated via a translated and culturally adapted Urdu version of the International Index of Erectile Function (IIEF - 5) questionnaire. For each patient the questionnaire was filled twice before surgery and 3 months after surgery based on their sexual activity condition. Overall IIEF score before and after urethroplasty was calculated to see mean change in IIEF score.Results: Mean age of patients was 41.13±11.10 years. Mean body mass index (BMI) of patients was 24.41±3.52 Kg/m². Mean duration of symptoms of PFUIs was 8.74±3.5 months. Mean duration of marriage was 16.96±8.86 years. On comparison of before surgery and after surgery IIEF score, before surgery IIEF score was 20.10±3.47 and after surgery was 19.80±3.35 (p-value 0.119). Mean IIEF score was 19.82±3.33 in patients having age ≤40 years versus 19.78±3.42 in patients having age >40 years (p-value 0.04). Conclusion: There is no effect of surgery on erectile function in patients of post-fracture urethral injuries (PFUIs). We found significant effect of age on erectile function after surgery in these patients. Keywords: Pelvic fracture urethral injuries (PFUIs), urethroplasty, erectile dysfunction,