Pelvic Fractures and Sexual Activity After Injury

Pelvic complex fractures and sexual activity?

Hello Doctor, I had an accident on August 13th where I fell from a height of 12.7 meters, resulting in a complex pelvic fracture and internal bleeding.
On October 6th, my husband was very eager to engage in sexual activity.
I felt guilty for not fulfilling my marital duties, so I painfully went through with it (due to injury to the cauda equina, I had blood in my urine from the catheter, and the obstetrician said it might be due to friction).
I only realized yesterday that sexual activity can occur anywhere, but the pelvis needs to heal before engaging in sex.
I also saw cases where sexual activity led to the pelvic plate becoming misaligned and a screw loosening, which made me very worried because I truly didn't know that I shouldn't have sex.
The thought of a loose screw and a misaligned plate is terrifying, and I am very anxious.
On October 16th, I experienced pain similar to postpartum pain during intercourse.
My follow-up appointment is on November 19th, and I didn't think about this issue at that time.
The next follow-up will be on December 19th.
I would like to know if the doctor will be able to see any abnormalities like a misaligned plate or loose screws on the X-ray taken on November 19th, or will a CT scan be necessary? This is causing me a lot of worry.
Please help me, Doctor.

Ms. Lin, 30~39 year old female. Ask Date: 2022/12/02

Dr. Shi Guozheng reply Orthopedics

Your attending physician is the most familiar with your condition, so make sure to ask questions clearly during your appointment or write them down beforehand to address them one by one.
Typically, pelvic fractures heal in about three to six months; if you are still experiencing pain, it may be due to other issues.

Reply Date: 2022/12/02

More Info

Understanding pelvic fractures and the implications for sexual activity after such an injury is crucial for both physical and emotional recovery. Pelvic fractures can be complex injuries that not only affect the bones but can also impact surrounding soft tissues, nerves, and organs. Given your situation, where you experienced a complex pelvic fracture and subsequent complications, it is essential to approach the topic of sexual activity with caution and awareness.

Firstly, pelvic fractures typically require a healing period of approximately three to six months, depending on the severity of the fracture and the individual's overall health. During this time, it is vital to allow the body to heal adequately. Engaging in sexual activity too soon can lead to complications such as misalignment of surgical hardware (like plates and screws), increased pain, and even further injury. The concern you mentioned about the potential for screws to loosen or plates to shift is valid, especially if sexual activity causes undue stress on the healing bones.

Regarding your specific concerns about whether X-rays can detect issues with the surgical hardware, it is important to note that while X-rays are useful for assessing the alignment of bones and the presence of hardware, they may not always provide a complete picture. In some cases, a CT scan may be necessary to evaluate the position of screws and plates more accurately. If your doctor did not mention any abnormalities during your last visit, it is likely that the hardware was in the correct position at that time. However, if you continue to experience pain or discomfort, it would be prudent to discuss further imaging options with your healthcare provider.

In terms of sexual activity, it is crucial to listen to your body. If you experience pain during intercourse, it may be a sign that you are not yet ready for that level of physical activity. The pain you described, akin to postpartum discomfort, could indicate that your body is still healing. It is advisable to wait until you receive clearance from your healthcare provider before resuming sexual activity. They can provide personalized guidance based on your healing progress and any specific risks associated with your injury.

Moreover, the psychological aspect of resuming sexual activity after such a traumatic injury should not be overlooked. It is common to feel anxious or fearful about engaging in sexual activity after experiencing significant pain or injury. Open communication with your partner about these feelings can help both of you navigate this sensitive topic together.

In summary, while sexual activity is a natural part of intimate relationships, it is essential to prioritize your healing process after a pelvic fracture. Consult with your healthcare provider about when it is safe to resume sexual activity, and consider discussing any concerns you have about pain or the integrity of your surgical hardware. Remember that healing is a gradual process, and taking the time to recover fully will benefit both your physical health and your intimate relationship in the long run.

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