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      Retrograde Ejaculation Due to Posterior Urethral Stricture: A Rare Case Report

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          Abstract

          Pelvic fracture is a serious injury, which has a profound impact on sexual function due to concurrent nervous and urethral injuries. In this case report, we describe a 29-year-old single man who had retrograde ejaculation as a result of a pelvic fracture-related posterior urethral stricture. The patient wanted to improve his ejaculatory ability after experiencing urethral stricture for 8 years and retrograde ejaculation for 3 years following the pelvic fracture. We precisely located and measured the patient’s urethral stricture using a retrograde urethrogram, and we used transrectal color Doppler ultrasound to track the patient’s ejaculation process in real time. Next, we used urethral balloon dilatation to relieve the urethral stricture. Urinary obstruction symptoms have completely resolved, and the patient was able to urinate without any obstructions. Meanwhile, the real-time transrectal color Doppler ultrasound result showed that some semen might ejaculate externally by passing through the initial stricture area, while some semen continued to flow retrogradely into the bladder.

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          Most cited references12

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          European Association of Urology Guidelines on Sexual and Reproductive Health—2021 Update: Male Sexual Dysfunction

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            Genitourinary injuries in pelvic fracture morbidity and mortality using the National Trauma Data Bank.

            Pelvic fractures from blunt force trauma place the bladder and urethra at risk for injury, often resulting in significant complications. We sought to compare morbidity, mortality, and health care resource utilization in patients with and without genitourinary injuries (GUI) associated with pelvic fractures. In this retrospective study of patients with blunt force pelvic fractures, the incidence of GUI, initial emergency department data, mechanism of injury, morbidity, health care resource utilization, associated injuries, discharge disposition, and mortality were investigated using chi tests for categorical variables and Student's t test for continuous variables comparing pelvic fractures with and without GUI. Multiple logistic regression analysis was used to detect significant predictors of mortality. Of the 31,380 patients with pelvic fractures, 1,444 had GUI. Men more commonly sustained pelvic fractures with GUI than women (66.14% vs. 33.86%). The incidence of urogenital, bladder, and urethral injuries for men and women was 5.34%, 3.41%, 1.54%, and 3.62%, 3.37%, 0.15%, respectively. Patients with GUI remained hospitalized longer (median 10 vs. 6 d, p or=65 years, initial systolic blood pressure in the emergency department 0 mm Hg to 90 mm Hg, Injury Severity Score >or=25, Glasgow coma score of
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              Pelvic ring fractures are an independent risk factor for death after blunt trauma.

              It is unknown whether pelvic ring fracture is an independent predictor of death after blunt trauma. Few previous studies have attempted to analyze whether the high death rate observed in association with pelvic ring injury is secondary to the pelvic ring injury or merely related to many other injuries that typically are sustained in such cases. Our hypothesis was that pelvic ring fracture is an independent risk factor for death, even after accounting for the risk of death from other associated injuries.
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                Author and article information

                Journal
                Am J Mens Health
                Am J Mens Health
                JMH
                spjmh
                American Journal of Men's Health
                SAGE Publications (Sage CA: Los Angeles, CA )
                1557-9883
                1557-9891
                13 September 2024
                Sep-Oct 2024
                : 18
                : 5
                : 15579883241276986
                Affiliations
                [1 ]Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian, China
                [2 ]Department of Andrology, Peking University First Hospital, Beijing, China
                Author notes
                [*]Hui Jiang, Department of Andrology, Peking University First Hospital, Beijing 100191, China. Email: jianghui55@ 123456163.com
                [*]Tao Jiang, Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Liaoning 116023, China. Email: jiangt69@ 123456163.com
                [*]

                Lei Zheng and Lihong Wang contributed equally to this work as co-first authors.

                Author information
                https://orcid.org/0009-0004-5164-6511
                Article
                10.1177_15579883241276986
                10.1177/15579883241276986
                11401143
                39268990
                ce239ed8-bc6a-4eb6-958b-17e261089be3
                © The Author(s) 2024

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 29 May 2024
                : 10 July 2024
                : 24 July 2024
                Funding
                Funded by: Natural Science Foundation of Liaoning Province, FundRef https://doi.org/10.13039/501100005047;
                Award ID: 201502037
                Funded by: National Natural Science Foundation of China, FundRef https://doi.org/10.13039/501100001809;
                Award ID: 21272032
                Categories
                Case Report
                Custom metadata
                September-October 2024
                ts1

                retrograde ejaculation,urethral stricture,transurethral balloon dilation,pelvic fracture

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