The Correlation Research Of Ischiocavernosus Injuries With Different Types Of Pelvic Fractures And ED After Pelvic Fractures

Objective: To evaluate the incidence of erectile dysfunction after different types of pelvic fractures in men with ischiocavernosus injuries and the relationship between different types of pelvic fractures and erectile dysfunction after pelvic fractures.Methods: Regression analysis of clinical data of pelvic fracture patients in our hospital in recent 8 years,The risk factors were identified based on the type of pelvic fractures recorded and the presence or absence of ischiocavernosus injuries which identified by electromyography and CT/MRI.The presence of erectile dysfunction in each patient was followed up through the IIEF-5 questionnaire.Multivariate Logistic regression analysis was used to evaluate the relationship between erectile dysfunction and different types of pelvic fractures and ischial cavernous muscle injuries.Results: A total of 776 male patients with pelvic fracture in our hospital were collected?212 patients with erectile dysfunction after pelvic fracture(27.3%).Age is mainly concentrated between 21-50 years old.The incidence of ischiocavernosus injury and erectile dysfunction is the highest when pubic symphysis is separated(60.56%,74.65%).The ischial spongiform myogenic erectile dysfunction 116 cases,accounting for 54.72% of ED after pelvic fracture.In multivariate Logisticregression analysis showed that Bilateral pubic ramus fracture(OR=15.050,P=0.000,95%CI 6.359-35.620),Bilateral sciatic branch fracture(OR=17.911,P=0.003,95%CI 2.691-119.222),Unilateral ischiocavernosus injury(OR=16.829,P=0.000,95%CI 5.854-48.377),Bilateral ischiocavernosus injury(R=26.020,P=0.000,95%CI 5.511-122.858),Combined with posterior urethral injury(OR=3.67,P=0.015,95%CI1.285-10.536)and Pubic Symphysis Diastasis(OR=2.687,P=0.048,95%CI 1.008-7.158)were identified as risk factors for erectile dysfunction after pelvic fracture.In multivariate Logisticregression analysis showed that Bilateral pubic ramus fracture(OR=43.751 P=0.000,95%CI 9.270-206.492),Pubic Symphysis Diastasis(OR=10.384 P=0.000,95%CI 4.350-24.786),Surgical treatment of pelvic fractures(OR=4.065 P=0.000,95%CI 2.483-6.657)were identified as risk factors for ischiocavernosus injury after pelvic fracture.Unilateral sciatic cavernous muscle injury(OR=2.856,P=0.009,95%CI1.295-6.301)was identified as risk factor for temporary erectile dysfunction,Bilateral sciatic spongiform muscle injury(OR=25.414,P=0.000,95%CI7.211,89.562)was identified as risk factor for perpetual erectile dysfunction.Conclusions:1?The pubic skeletal fracture and pubic symphysis separation may be the main causes of ischiocavernosus injury;2?The fracture of pubic ramus and separation of pubic symphysis may led to erectile dysfunction through injury of ischiocavernosus;3?Unilateralischiocavernosus injury may be the main cause of transient erectile dysfunction;bilateral ischiocavernosus injury may be the main cause of permanent erectile dysfunction.