Sexual function impairment among surgically treating patients with acetabular fracture: a retrospective study.

BACKGROUND

This study aimed to investigate the midterm effect of surgical treatment on sexual function in patients with acetabular fracture. Additionally, we explored the predictors of the postoperative sexual function impairment in this patient population.

METHODS

Patients treated for acetabular fracture at our facility between 2018 and 2021 were enrolled. All participants were followed up for a minimum of 12 months postoperatively. Sexual function was assessed using the International Index of Erectile Function 15 (IIEF-15) questionnaire for male patients and the Female Sexual Function Index (FSFI) for female patients. Data on patient demographics, fracture classification, injury severity score (ISS), comorbidity, treatment details (duration of operation and surgical approach), and Harris hip score (HHS) were collected from institutional registry. Multiple stepwise linear regression was used to identify predictors of sexual function impairment.

RESULTS

A total of 94 patients consented to participate, with a mean follow-up duration of 19.4 ± 3.1 months. The mean age of patients were 45.7 ± 12.3 years. A significant decrease of total sexual function score were observed in both male (P < 0.0001) and female (P < 0.0001) patients. Among six FSFI domains, sexual desire, orgasm, satisfaction and pain scores showed statistical reductions, while the decrease in arouse and lubrication did not show statistically significant change. In male patients, four IIEF-15 domains, including erectile function, orgasmic function, intercourse satisfaction and overall satisfaction were significantly decreased, whereas sexual desire was not significantly affected. In male patients, older age and lower HHS were independently associated with greater sexual dysfunction (P < 0.001 and P = 0.02, respectively; R2 = 0.53). The corresponding predictive equation was: Y(IIEF15 score) = 34.41–0.59×age (years old) + 0.62 ×HSS (score). In female patients, the older age and lower HHS were also significantly related to worse sexual function(P < 0.001 and P < 0.001, respectively; R2 = 0.69). A predictive equation derived as follows: Y(FSFI score) = 6.64 − 0.1×age (years old) + 0.31 ×HSS (score).

CONCLUSION

Patients undergoing surgical treatment for acetabular fracture experience sexual function impairment at a minimum of one year postoperatively. Age and Harris Hip Scores are independent predictors of postoperative sexual function impairment.