Müjdat ADAŞ, Ali Çağrı TEKİN, Mehmet Kürşad BAYRAKTAR, Murat ÇAKAR, Samet ASLAN, CEM ZEKİ ESENYEL

Effects of the lower extremity external fixators on the sexual life of males

Objective: In tibial fractures, the use of an external fixator (EF) may be associated with sexual dysfunction (SD) in sexually active male patients. We aimed to investigate the influence of EF applied for tibial fracture on the sexual life in male patients.Methods: We retrospectively evaluated 137 male patients who presented with tibial fractures and underwent surgical intervention with unilateral or circular EF. The patients completed the Brief Sexual Function Inventory (BSFI) form during the interview. We evaluated the incidence of the development of SD and the severity of SD with the use of an EF, and the relation with the type of EF and SD was investigated. The responses were compared with the results of the completed BSFI forms of 119 male patients who were treated with internal fixation (IF) for tibial fractures.Results: In total, 108 patients (mean age, 42.8 years) treated with EF accepted the invitation and filled the form. The score of those patients were worse compared with that of the patients who were treated with IF (P < 0.001). Postoperative sexual functions were the same with the preoperative sexual function in 12 patients (11%). However, the postoperative scores were decreased in 96 (89%) patients, which meant that the sexual functioning was impaired. None of the patients reported persistent SD.Conclusion: EF in the cruris may impair sexual functions in males. The rate of SD was higher in male patients who were treated with EF. Thus, SD might be associated with physical, psychological, and social limitations caused by EF.

___

Wright JL, Nathens AB, Rivara FP, MacKenzie EJ, Wes- sells H. Specific fracture configurations predict sexual and excretory dysfunction in men and women 1 year after pel- vic fracture. J Urol 2006;176(4 Pt 1):1540-5.

Sorensen MD, Wessells H, Rivara FP, Zonies DH, Jurkov- ich GJ, Wang J, et al. Prevalence and predictors of sexual dysfunction 12 months after major trauma: a national study. J Trauma 2008;65:1045-53.

Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537-44.

Rosen RC. Prevalence and risk factors of sexual dysfunc- tion in men and women. Curr Psychiatry Rep 2000;2:189- 95.

Laumann EO, Paik A, Glasser DB, Kang JH, Wang T, Levinson B, et al. A cross-national study of subjective sexu- al well-being among older women and men: findings from the Global Study of Sexual Attitudes and Behaviors. Arch Sex Behav 2006;35:145-61.

Read S, King M, Watson J. Sexual dysfunction in pri- mary medical care: prevalence, characteristics and detec- tion by the general practitioner. J Public Health Med 1997;19:387-91.

O'Leary MP, Fowler FJ, Lenderking WR, Barber B, Sa- gnier PP, Guess HA, et al. A brief male sexual function inventory for urology. Urology 1995;46:697-706.

Ozumba D, Starr AJ, Benedetti GE, Whitlock SN, Fraw- ley WH. Male sexual function after pelvic fracture. Ortho- pedics 2004;27:313-8.

Vincent EE, Singh SJ. Review article: addressing the sexual health of patients with COPD: the needs of the patient and implications for health care professionals. Chron Respir Dis 2007;4:111-5.

Stolk EA, Busschbach JJ. Are patients and the general pub- lic like-minded about the effect of erectile dysfunction on quality of life? Urology 2003;61:810-5.

Metze M, Tiemann AH, Josten C. Male sexual dysfunction after pelvic fracture. J Trauma 2007;63:394-401.

Ulvik A, Kvåle R, Wentzel-Larsen T, Flaatten H. Sexual function in ICU survivors more than 3 years after major trauma. Intensive Care Med 2008;34:447-53.

Nicolosi A, Laumann EO, Glasser DB, Moreira ED Jr, Paik A, Gingell C. Sexual behavior and sexual dysfunc- tions after age 40: the global study of sexual attitudes and behaviors. Urology 2004;64:991-7.

Ansong KS, Lewis C, Jenkins P, Bell J. Help-seeking deci- sions among men with impotence. Urology 1998;52:834- 7.