Abstract
Blunt pelvic and perineal trauma has been previously reported to result in site-specific veno-occlusive dysfunction and/or site-specific cavernosal artery insufficiency. We herein describe a case of erectile dysfunction in a young previously potent amputee. We postulate that the erectile dysfunction is associated with a newly described form of blunt trauma, that is, site-specific compression from a perineal weight-bearing lower extremity above-knee prosthetic device. It is hypothesized that when the force exerted by the above-knee prosthesis is directed medially towards the ischiopubic ramus, the penile crura and common penile arterial blood supply become susceptible to crush-like injury, since they are in fixed anatomic locations in the perineum sandwiched between the compressive force and the bone. Clinical evaluation of the erectile dysfunction in this patient revealed site-specific corporal veno-occlusive dysfunction and site-specific common penile arterial occlusive pathology in the precise region of the contact of the above-knee prosthesis with the perineum. Further research is needed in above-knee prosthesis design to prevent erectile dysfunction.
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References
Schuch CM . Report from International Workshop on above-knee fitting and alignment techniques. Clin Prosth Orthot 1988;12: 77–90.
Levine FJ, Greenfield AJ, Goldstein I . Arteriographically-determined occlusive disease within the hypogastric-cavernous bed in impotent patients following blunt perineal and pelvic trauma. J Urol 1990; 144: 1147–1153.
Munarriz RM et al, Blunt trauma: the pathophysiology of hemodynamic injury leading to erectile dysfunction. J Urol, 1995; 153: 1831–1840.
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Munarriz, R., Kulaksizoglu, H., Hakim, L. et al. Lower extremity above-knee prosthesis-associated erectile dysfunction. Int J Impot Res 15, 290–292 (2003). https://doi.org/10.1038/sj.ijir.3901015
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DOI: https://doi.org/10.1038/sj.ijir.3901015