Introduction: Pelvic fracture urethral injury (PFUI) results from traumatic disruption of the urethra and is treated with anastomotic urethroplasty. Up to 60% of those patients have erectile dysfunction. Majority are treated with medical management. For those who fail, we perform penile implant. We present outcomes for a series of 41 patients who underwent penile implant insertion post anastomotic urethroplasty for PFUI. Methods: Our centre is a tertiary referral centre and published the world’s largest series of PFUI experience. We analyzed a prospectively maintained database of 41 patients who underwent penile implant insertion post PFUI. Choice of implant was based on patient’s preference and insurance coverage. Functional outcomes using the IIEF-5 questionnaire and complications were analyzed. Results: Mean delay between anastomotic urethroplasty and penile implant was 47 months. Semirigid penile implant was used in 92,7% of patients while three-piece inflatable penile implant was used in 7.3% of patients. Patients reported significant improvement in sexual function post implant with mean IIEF-5 score of 21.88 points compared to 3.27 points before the implant. Intraoperative complications included two septal perforations and one proximal crural perforation. Postoperative complications included two hematomas, two glans extrusion that were salvaged and one proximal urethral erosion that lead to implant removal Conclusions: Erectile dysfunction is a common occurrence in PFUI patients. Penile implant insertion in those patients is challenging due to ischemia of the corpora. If performed by experts, it is safe and leads to significant sexual function improvement. To date, this is the largest series of penile prosthesis insertion in PFUI patients post anastomotic urethroplasty. SOURCE OF Funding: None
