الفهرس 
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Abstract
Pelvic fracture urethral injuries cause urethral stricture or distraction defects which results in formation of fistula, false passage, other local complications and sexual dysfunction which is the most significant for the urologist.Post traumatic stricture of the posterior urethra, especially complex form, represents a surgical challenge. Although the last 3 decades have witnessed evolution of many procedures in the management of this urological problem debate still exists regarding many issues, as time of delayed repair of urethral stricture, urethrotomy versus urethroplasty,1-stage versus 2-stages urethroplasty, perineal versus transpubic urethroplasty and rate of sexual dysfunction following original trauma versus that following urethroplasty.The etiology of erectile dysfunction post pelvic fracture urethral injuries are vasculogenic in origin especially veno-occlusive cause and the incidence of erectile dysfunction is 72% which is severe in 33%. In addition, the cause of erectile dysfunction is the initial trauma not the anastomotic urethroplasty. However, patients with PFUI experienced statistically significant lower erectile function, intercourse and satisfaction and overall satisfaction. Also severity of pelvic trauma and patterns of pelvic fracture play an important role in causing ED as pelvic fracture type C, pubic diastasis, sacroiliac joint diastasis and bilateral pubic rami fracture are strong predictors of occurrence of ED.Recoverability of sexual function occurred in seven patients (13.5%) with the range between 4-24 months after trauma. In the same time severity of pelvic trauma, presence of pelvic fracture, type of pelvic fractures have negative impact on recoverability of sexual function.Anastomotic urethroplasty has good impact on ejaculatory function as all patients reported antegrade ejaculation after surgery except two patients who had decreased force of ejaculation so the effect of splitting of bulbocavernous muscle is minimal.To sum up, PFUIs have a propability of causing ED as much as 72.3% compared to 35.3 and 0% in men with straddle and iatrogenic urethral injuries, respectively.Anastomotic urethroplasty has no negative impact on EF as none of the patients with normal EF before urethroplasty developed de novo ED after surgery.Recovery of EF could be predicted from two factors,namely the etiology of urethral trauma and the severity of pelvic fracture. Patients who sustain PFUIs have a 9% of regaining EF compared to 28.6 and 100% in patients with straddle and iatrogenic urethral injuries,respectively.None of the patients with severe pelvic fracture(type C) had chance to regain their EF.In addition, nearly all men maintained antegrade ejaculation after PFUIs repair.The risk of splitting the bulbocavernous muscle on ejaculation is minimal.However,objective testing is required to accurately estimate the effects of bulbocavernous muscle splitting on its contraction and EjF.