Sexual Activity after Total Hip Replacement in Korean Patients: How They Do, What They Want, and How to Improve

Abstract

BackgroundConcerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients?MethodsDetails of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic.ResultsPreoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic.ConclusionsDislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.

High Rates of Interest in Sex in Patients With Hip Arthritis

“…Difficulties having sex is a major factor that affects the quality of life of patients before undergoing THA [13,15,16]. Many patients attribute these difficulties to the underlying hip arthritis and expect an improvement in their sexual activities or participating in such activities as a result of their THA [9,12,15].…”

“…Limitations in sexual activity are common among patients with hip arthritis [6] and patients often express that these issues can cause unhappiness or tension in their relationships [6,10,16]. Although patients frequently do not explicitly mention better sexual function as a desired result of surgery, many expect improvement after THA [9,12,15].…”

Does total hip replacement affect sexual quality of life?

“…As human beings can be sexually active at all ages [ 12 ], the total number of sexually active patients undergoing THR will increase. Given the fact that SF is seldom discussed, [ 12 ], Sexual Difficulty (SD) might be under-diagnosed in patients with HA; however, while there are some recent international studies into this topic [ 13 – 15 ], an overview of the literature is lacking. The aim of this study, therefore, was to provide a systematic review of the literature, with the aim of summarising the effects of THR on patients’ SQoL.…”

Patient sexual function and hip replacement surgery: A survey of surgeon attitudes

“…The patients' fear for dislocation has been emphasized (up to 80%) in previous literature [8]. In addition, the female patients in this study changed their preferred sexual positions after THA in non-recommended positions, mostly due to difficulties with the leg position [8]. Unknown is if this would lead to more dislocations of the prosthesis more easily.…”

“…Authors suggest SF should be routinely addressed with all patients undergoing THA [2]. Within fifty years of research, only a few studies have examined the impact of HA on SF and improvement of SF after THA [3][4][5][6][7][8][9]. Since 1991, Stern et al (1991) found that nearly 80% of patients (who were satisfied with the THA result) felt the need for more information about SF afterwards; and in 20% sexual dysfunction (SD) had been an argument to undergo THA [4].…”