Comparison of Micturition, Sexual and Defecation Disorders in Females Following type B and C Pelvic Fractures

Česká verzia

Authors: V. Džupa ^1,2; M. Očenášek ^1,3; J. Vránová ⁴; V. Ducháč ⁵; R. Grill ^1,6; V. Báča ^1,7
Authors place of work: Centrum pro integrované studium pánve 3. LF UK, Praha, vedoucí lékař: doc. MUDr. Robert Grill, Ph. D. ¹; Ortopedicko-traumatologická klinika 3. LF UK a FNKV, Praha, přednosta: doc. MUDr. Martin Krbec, CSc. ²; Ústav pro péči o matku a dítě, Praha, ředitel: doc. MUDr. Jaroslav Feyereisl, CSc. ³; Ústav lékařské biofyziky a informatiky 3. LF UK, Praha, přednosta: doc. MUDr. Jozef Rosina, CSc. ⁴; Chirurgická klinika 3. LF UK a FNKV, Praha, přednosta: prof. MUDr. Robert Gürlich, CSc. ⁵; Urologická klinika 3. LF UK a FNKV, Praha, přednosta: doc. MUDr. Robert Grill, Ph. D. ⁶; Ústav anatomie 3. LF UK, Praha, přednosta: prof. MUDr. Josef Stingl, CSc. ⁷
Published in the journal: Rozhl. Chir., 2011, roč. 90, č. 10, s. 579-583.
Category: Monothematic special - Original

Summary

Introduction:
The objective of this work is to present results obtained in a three-year study focussed on micturition, defecation and sexual disorders in women of active age.

Methods:
The monitored set consisted of 33 female patients treated in 2004–2009 for unstable pelvic fracture (B-type or C-type according to AO classification). Out of them 25 patients suffered B-type fracture and 8 patients suffered C-type fracture. Their age ranged between 17 and 55 years (the average age was 32 years).

Anamnestic data were obtained based on UIQ, UDI and PISQ12 questionnaires.

The non-parametric Mann-Whitney U-test was used for answers to individual questions representing nominal/ordinal variables. After finding a statistically significant difference in answers between both groups of patients, it was investigated by means of Pearson χ²-test which answers are behind this statistically significant difference. If the number of answers to any question was less than 5, the exact Fisher test was used. In the event the rate equalled 0, Haldane correction was applied. All tests were considered statistically significant if the significance level was below 5%.

Results:
The occurrence of urologic problems was higher in the B-type fracture patients (84% vs. 50%), however, afflictions were more severe in the C-type fracture patients. Intestinal problems were more frequent in the C-type fracture patients (75% vs. 52%) and they were also more severe. Also sexual problems were more frequent in the C-type fracture patients (75% vs. 40%), although according to individual answers it was not possible to state that their sexual life was unequivocally worse.

Conclusion:
The analysis of comparison of micturition, sexual and defecation problems in patients one year after the unstable pelvic fracture showed in some respects higher problems in the patients who had suffered the C-type fracture. However, more important are the following observations, generally related to unstable pelvic fracture patients: 1. The occurrence of micturition, sexual and defecation problems was unexpectedly high; 2. Without active examination by a traumatologist during the after-treatment ”minor” problems may escape his/her attention and may negatively affect life of each individual patient in the longer run; 3. A targeted method of detection of problems by means of questionnaires could lead to their disclosure; 4. A urologist, urogynaecologist, sexologist and proctologist have an indisputable place in the treatment of women who suffered a severe pelvic trauma.

Key words:
urinary incontinence – voiding dysfunction – sexual dysfunction – instable pelvic fracture

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