Nerve&artery injury: Injury to the urethra is usually associated with severe pelvic trauma in males. The results of such an injury can have enduring consequences that include stricture, impotence, and incontinence. Impotence has an incidence of 13% to 30% in patients with pelvic fracture and urethral distraction injury treated with early catheter placement (without pelvic-suprapubic exploration). These patients presumably had less-severe urethral disruption. Impotence was much higher (48%–72%) in a group of patients who ultimately required open repair and likely had more-severe, complete urethral distraction. Secondary damage to the penile parasympathetic nerves (cavernosal nerves lateral to the prostatomembranous urethra behind the symphysis) and arterial insufficiency are believed to account for impotence in these injuries. Disruption of the pubis is the most likely cause of impotence in this injury. The severe injuries that lead to posterior urethral injuries can also damage the delicate nerves that run alongside the urethra deep within the body and provide the signal to the penis to become erect for sexual activity. Approximately 50% of men who have urethral injuries from pelvic fractures will have some degree of erectile dysfunction once they recover. This may range from very mild to complete erectile dysfunction, but several treatment options do exist. Erectile dysfunction caused by the surgery to repair the urethra (rather than the injury itself) is uncommon.
Answered 7/29/2015
6.4k views
Bad injury: Lots of significant vessels and nerves in the area. Healing takes time. Hope you recover without interventions. Urology may be able to help.
Answered 3/31/2013
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