{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:31:51Z","timestamp":1791765111856,"version":"4.3.4"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Erectile dysfunction (ED) is a common and multifactorial complication after pelvic fracture urethral injury (PFUI), yet objective characterization of ED severity and penile Doppler findings remains limited. We aimed to describe ED severity categories and penile Doppler findings in men with PFUI undergoing anastomotic urethroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of a prospectively maintained database. Among 110 men who underwent anastomotic urethroplasty for PFUI between September 2022 and September 2023, 97 with complete preoperative penile Doppler ultrasound and standardized Sexual Health Inventory for Men assessment were included. Pelvic fractures were classified using the Young\u2013Burgess system. All patients received tadalafil 5 mg daily for 6 months. Postoperative Doppler was not performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The median age was 29.5 years with a median follow-up of 11 months. Urethroplasty success rate was 85%(83\/97). Preoperatively, 56 out of 97 patients had ED (42 mild\/moderate; 14 severe). Penile Doppler abnormalities were nearly universal: 93 had cavernosal, and 83 had dorsal artery insufficiency. Postoperatively, 13 out of 41 men developed de novo ED, while 13 out of 56 improved by at least one severity category. Among 76 patients with complete fracture data, greater fracture severity was associated with worse postoperative ED, and worsening erectile function was more frequent among patients with urethroplasty failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ED and penile Doppler abnormalities are highly prevalent after PFUI. ED severity correlated with pelvic injury severity, supporting the concept that ED reflects global trauma burden rather than isolated vascular pathology. Given the retrospective design and routine postoperative use of PDE5 inhibitors, these findings should be considered descriptive and hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/iju.iju_557_25","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T14:00:10Z","timestamp":1776348010000},"page":"207-212","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Erectile dysfunction severity and penile Doppler findings in pelvic fracture urethral injury: A descriptive cohort study"],"prefix":"10.4103","volume":"42","author":[{"given":"Pankaj Mangalkumar","family":"Joshi","sequence":"first","affiliation":[{"name":"Reconstructive Urology Department, Urokul Hospital, Mumbai \u2013 Pune Bypass Road, Next to Bitwise Terra Towers, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wattanachai","family":"Ratanapornsompong","sequence":"additional","affiliation":[{"name":"Reconstructive Urology Department, Urokul Hospital, Mumbai \u2013 Pune Bypass Road, Next to Bitwise Terra Towers, Pune, India"},{"name":"Urology Division, Surgical Department, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Antonia","family":"Ocampo","sequence":"additional","affiliation":[{"name":"Reconstructive Urology Department, Fundaci\u00f3n Valle Del Lili Hospital, Cali, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimena","family":"Navarro","sequence":"additional","affiliation":[{"name":"Reconstructive Urology Department, Urokul Hospital, Mumbai \u2013 Pune Bypass Road, Next to Bitwise Terra Towers, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saket S.","family":"Patwardhan","sequence":"additional","affiliation":[{"name":"Reconstructive Urology Department, Urokul Hospital, Mumbai \u2013 Pune Bypass Road, Next to Bitwise Terra Towers, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunter","family":"DeWin","sequence":"additional","affiliation":[{"name":"ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium"},{"name":"Department of Urology, Antwerp University Hospital, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Thiessen","sequence":"additional","affiliation":[{"name":"ASTARC, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium"},{"name":"Department of Plastic and Reconstructive Surgery, Antwerp University Hospital, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Wood","sequence":"additional","affiliation":[{"name":"Urology Department, University of Colorado \u2013 School of Medicine, Aurora, CO, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay B.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Reconstructive Urology Department, Urokul Hospital, Mumbai \u2013 Pune Bypass Road, Next to Bitwise Terra Towers, Pune, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"R1-20260701","doi-asserted-by":"crossref","first-page":"S29","DOI":"10.21037\/tau.2017.12.35","article-title":"Pelvic fracture urethral injury in males-mechanisms of injury, management options and outcomes","volume":"7","author":"Barratt","year":"2018","journal-title":"Transl Androl Urol"},{"key":"R2-20260701","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1016\/S0022-5347(05)68918-5","article-title":"Pelvic fracture urethral injuries: The unresolved controversy","volume":"161","author":"Koraitim","year":"1999","journal-title":"J Urol"},{"key":"R3-20260701","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/01.ju.0000146683.31101.ff","article-title":"On the art of anastomotic posterior urethroplasty: A 27-year experience","volume":"173","author":"Koraitim","year":"2005","journal-title":"J Urol"},{"key":"R4-20260701","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0022-5347(17)38442-2","article-title":"Repair of pelvic fracture posterior urethral defects using an elaborated perineal approach: Experience with 74 cases","volume":"145","author":"Webster","year":"1991","journal-title":"J Urol"},{"key":"R5-20260701","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1038\/ijir.2016.18","article-title":"Erectile function after anastomotic urethroplasty for pelvic fracture urethral injuries","volume":"28","author":"El-Assmy","year":"2016","journal-title":"Int J Impot Res"},{"key":"R6-20260701","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1590\/S1677-5538.IBJU.2014.0170","article-title":"The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures","volume":"41","author":"Guan","year":"2015","journal-title":"Int Braz J Urol"},{"key":"R7-20260701","doi-asserted-by":"crossref","first-page":"2043","DOI":"10.21037\/tau-20-1287","article-title":"Sexual function following pelvic fracture urethral injury and posterior urethroplasty","volume":"10","author":"Mazzone","year":"2021","journal-title":"Transl Androl Urol"},{"key":"R8-20260701","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1111\/j.1464-410X.2009.08589.x","article-title":"Erectile function after posterior urethroplasty for pelvic fracture-urethral distraction defect injuries","volume":"104","author":"Anger","year":"2009","journal-title":"BJU Int"},{"key":"R9-20260701","doi-asserted-by":"crossref","first-page":"3328","DOI":"10.21037\/tau-2025-186","article-title":"Management of pelvic fracture urethral injury","volume":"14","author":"Joshi","year":"2025","journal-title":"Transl Androl Urol"},{"key":"R10-20260701","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1111\/bju.16710","article-title":"Bulbar urethral necrosis: Current concept and novel comprehensive classification","volume":"136","author":"Joshi","year":"2025","journal-title":"BJU Int"},{"key":"R11-20260701","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.2214\/AJR.19.22141","article-title":"Penile Doppler ultrasound for erectile dysfunction: Technique and interpretation","volume":"214","author":"Varela","year":"2020","journal-title":"Am J Roentgenol"},{"key":"R12-20260701","doi-asserted-by":"crossref","first-page":"2338","DOI":"10.1007\/s11999-014-3693-8","article-title":"Classifications in brief: Young and burgess classification of pelvic ring injuries","volume":"472","author":"Alton","year":"2014","journal-title":"Clin Orthop Relat Res"},{"key":"R13-20260701","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1038\/sj.ijir.3901327","article-title":"The sexual health inventory for men (SHIM): A 5-year review of research and clinical experience","volume":"17","author":"Cappelleri","year":"2005","journal-title":"Int J Impot Res"},{"key":"R14-20260701","doi-asserted-by":"crossref","first-page":"319","DOI":"10.5152\/tud.2021.21065","article-title":"Redo pelvic fracture urethral injury repair: The case for tadalafil","volume":"47","author":"Joshi","year":"2021","journal-title":"Turk J Urol"},{"key":"R15-20260701","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1111\/andr.12015","article-title":"Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: Diagnosis, treatment, and outcomes","volume":"3","author":"Sangkum","year":"2015","journal-title":"Andrology"}],"container-title":["Indian Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_557_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:10Z","timestamp":1786647490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/iju.iju_557_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,14]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/iju.iju_557_25","relation":{},"ISSN":["0970-1591","1998-3824"],"issn-type":[{"value":"0970-1591","type":"print"},{"value":"1998-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,14]]},"assertion":[{"value":"2025-11-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}