Objective: To explore the aetiology, diagnosis,and treatment of erectile dysfunction (ED) after a pelvic fracture urethral injury.
Methods: Rigiscan and Duplex ultrasound were used to determine the causes of ED induced by pelvic fracture urethral injury in 29 patients and the therapeutic means were also analyzed.
Results: Of the 29 patients, 1 was psychological, 28 were physical, 7 vascular, and 15 neurological. Rigiscan and Duplex ultrasound revealed the cause of erectile failure as neurogenic in 15. Twenty-three cases were effective by the therapy. The injection with vasoactive agents (prostagland in E1) was successful in 15, Viagra in 2, Befar in 5, and revascularization of epigastric artery-dorsal artery anastomosis in 1.
Conclusion: Disruption of the cavernous nerves lateral to the prostatomembranous urethra is the most likely cause of ED in this injury. Intracavernous injection of prostaglandin E1 is believed to be safe and effective for ED.