[Pelvic fracture and urogenital dysfunction in women: A literature review]

Abstract

Introduction: The consequences of a pelvic fracture on pelvic statics and sexuality in women are often overlooked and relegated to secondary care.

Objective: To carry out a state of knowledge on disorders of pelvic statics and sexuality in patients with a history of pelvic fracture: incidence, risk factors, management.

Methods: Literature review on the Pubmed, Medline, Embase and Cochrane database using the following keywords and MeSH terms: pelvis floor dysfunction, urinary dysfunction, sexual dysfunction, pelvic organ prolapse, in association with the terms pelvic fracture, pelvic trauma.

Results: Among the 270 initial articles, 21 were selected. Finally, one retrospective cohort study has evaluated the impact of pelvic fracture on the onset of a genital prolapse, 2 comparative retrospective studies and one prospective study focused on the impact of pelvic fracture on lower urinary tract symptoms. One comprehensive review studied pelvic fracture and sexuality outcomes. The incidence of prolapse following pelvic fracture could not be identified. The incidence of lower urinary tract symptoms varies between 21 and 67% with a significant difference for urinary urgency without leakage (P=0.016) and SUI (P=0.004). The incidence of sexual disorders varies between 21 and 62% with a predominance of dyspareunia. The mechanism of the trauma is thought to be a contributing factor, as well as the damage of the pubic symphysis (RR 4.8 95% CI 2.0-11.2).

Conclusion: The evaluation of urogenital, sexual and anorectal dysfunctions following trauma to the pelvis has so far been little explored in the literature. Future prospective studies are to be carried out to improve patient care.

Keywords: Fracture du bassin; Genital prolapse; Incontinence; Pelvic fracture; Prolapsus génital; Sexuality; Sexualité.