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Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - A pilot study

Rajadoss Muthukrishna Pandian1, Nirmal Thampi John1, Anu Eapen2

  • 1Department of Urology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

International Braz J Urol : Official Journal of the Brazilian Society of Urology
|January 27, 2017
PubMed
Abstract

Insights

Magnetic Resonance Imaging (MRI) offers limited benefit for evaluating penile-urethral trauma in men with normal erections. However, MRI significantly correlates cavernosal injury with erectile dysfunction (ED) in these patients.

Area of Science:

  • Urology
  • Radiology
  • Medical Imaging

Background:

  • Penile fracture urethral distraction defects (PFUDD) can lead to erectile dysfunction (ED).
  • Preoperative evaluation is crucial for surgical planning and predicting outcomes.
  • The role of Magnetic Resonance Imaging (MRI) in assessing PFUDD and associated ED requires further clarification.

Purpose of the Study:

  • To evaluate the utility of MRI in the preoperative assessment of PFUDD.
  • To determine if MRI provides additional information regarding urethral distraction defects (UDD) and the causes of ED.
  • To correlate MRI findings with surgical outcomes and erectile function.

Main Methods:

  • Prospective study including male patients with PFUDD (Feb 2011-Dec 2012).
  • Exclusion criteria: traumatic spinal cord injury and pre-existing ED.
  • Assessment included IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU), and MRI pelvis.

Main Results:

  • Fifteen of twenty patients (75%) experienced ED, with seven (35%) having severe ED.
  • MRI findings associated with ED included longer UDD, cavernosal injury, rectal injury, retropubic scarring, and prostatic displacement.
  • Good surgical outcomes were observed in 60% of patients; poor outcomes correlated with rectal and cavernosal injuries.

Conclusions:

  • MRI did not significantly improve upon MCU for men with normal erections.
  • Cavernosal injury identified by MRI strongly correlated with ED.
  • MRI's role may be best suited for patients with ED or inconclusive MCU results.
Keywords:
Erectile DysfunctionPelvisSurveys and Questionnaires

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