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Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study
OBJECTIVES: To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? MATERIALS AND METHODS: In this prospective study, consecutive male patients presenting with PFUDD were i...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293393/ https://www.ncbi.nlm.nih.gov/pubmed/28124535 http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0252 |
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author | Pandian, Rajadoss Muthukrishna John, Nirmal Thampi Eapen, Anu Antonisamy, B. Devasia, Antony Kekre, Nitin |
author_facet | Pandian, Rajadoss Muthukrishna John, Nirmal Thampi Eapen, Anu Antonisamy, B. Devasia, Antony Kekre, Nitin |
author_sort | Pandian, Rajadoss Muthukrishna |
collection | PubMed |
description | OBJECTIVES: To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? MATERIALS AND METHODS: In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis. Primary end point was erectile function and secondary end point was surgical outcome. RESULTS: Twenty patients were included in this study. Fourteen patients (70%) were ≤40years; fifteen patients (75%) had ED, seven patients (35%) had severe ED. MRI findings associated with ED were longer median UDD (23mm vs. 15mm, p=0.07), cavernosal injury (100%, p=0.53), rectal injury (100%, p=0.53), retropubic scarring (60%, p=0.62) and prostatic displacement (60%, p=0.99). Twelve patients (60%) had a good surgical outcome, five (25%) had an acceptable outcome, three (15%) had a poor outcome. Poor surgical outcome was associated with rectal injury (66.7%, p=0.08), cavernosal injury (25%, p=0.19), retropubic scarring (18.1%, p=0.99) and prostatic displacement (16.7%, p=0.99). Five patients with normal erections had good surgical outcome. Three patients with ED had poor outcome (20%, p=0.20). CONCLUSIONS: MRI did not offer significant advantage over MCU in the subgroup of men with normal erections. Cavernosal injury noted on MRI strongly correlated with ED. Role of MRI may be limited to the subgroup with ED or an inconclusive MCU. |
format | Online Article Text |
id | pubmed-5293393 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-52933932017-02-08 Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study Pandian, Rajadoss Muthukrishna John, Nirmal Thampi Eapen, Anu Antonisamy, B. Devasia, Antony Kekre, Nitin Int Braz J Urol Original Article OBJECTIVES: To study the usefulness of MRI in preoperative evaluation of PFUDD. Can MRI provide additional information on urethral distraction defect (UDD) and cause of erectile dysfunction (ED)? MATERIALS AND METHODS: In this prospective study, consecutive male patients presenting with PFUDD were included from Feb 2011 till Dec 2012. Those with traumatic spinal cord injury and pre-existing ED were excluded. Patients were assessed using IIEF questionnaire, retrograde urethrogram and micturating cystourethrogram (RGU+MCU) and MRI pelvis. Primary end point was erectile function and secondary end point was surgical outcome. RESULTS: Twenty patients were included in this study. Fourteen patients (70%) were ≤40years; fifteen patients (75%) had ED, seven patients (35%) had severe ED. MRI findings associated with ED were longer median UDD (23mm vs. 15mm, p=0.07), cavernosal injury (100%, p=0.53), rectal injury (100%, p=0.53), retropubic scarring (60%, p=0.62) and prostatic displacement (60%, p=0.99). Twelve patients (60%) had a good surgical outcome, five (25%) had an acceptable outcome, three (15%) had a poor outcome. Poor surgical outcome was associated with rectal injury (66.7%, p=0.08), cavernosal injury (25%, p=0.19), retropubic scarring (18.1%, p=0.99) and prostatic displacement (16.7%, p=0.99). Five patients with normal erections had good surgical outcome. Three patients with ED had poor outcome (20%, p=0.20). CONCLUSIONS: MRI did not offer significant advantage over MCU in the subgroup of men with normal erections. Cavernosal injury noted on MRI strongly correlated with ED. Role of MRI may be limited to the subgroup with ED or an inconclusive MCU. Sociedade Brasileira de Urologia 2017 /pmc/articles/PMC5293393/ /pubmed/28124535 http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0252 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Pandian, Rajadoss Muthukrishna John, Nirmal Thampi Eapen, Anu Antonisamy, B. Devasia, Antony Kekre, Nitin Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title | Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title_full | Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title_fullStr | Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title_full_unstemmed | Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title_short | Does MRI help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
title_sort | does mri help in the pre - operative evaluation of pelvic fracture urethral distraction defect? - a pilot study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293393/ https://www.ncbi.nlm.nih.gov/pubmed/28124535 http://dx.doi.org/10.1590/S1677-5538.IBJU.2016.0252 |
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