Laffosse Jean-Michel, Tricoire Jean-Louis, Chiron Philippe, Puget Jean
Service d'Orthopédie et de Traumatologie, CHU Rangueil, 1 avenue Jean Poulhès TSA 50032, 31059 Toulouse Cedex 9, France.
Joint Bone Spine. 2008 Mar;75(2):189-94. doi: 10.1016/j.jbspin.2007.05.006. Epub 2007 Aug 30.
Chronic hip pain can have an impact on the sexual activity of patients, all the more so if they are young.
Our department undertook a retrospective study using a questionnaire mailed out to 135 patients (58 women and 77 men) under 65 years of age who had undergone a total hip replacement (THA) with primary implant more than 6 months previously. The mean age of the patients was 51.8 years (22-65 years).
The age at which sexual difficulties first occurred was on average 45 years (21-63 years), or a mean of 2.5 years after the appearance of hip pain. Nineteen percent of patients considered their sexual difficulties to be severe to extreme. This caused tension or unhappiness in their relationship for 7% of patients. The cause for the difficulty was generally pain followed by stiffness. The patients with the most marked and earliest disorders were young women with hip dislocating anomalies. Multiarticular damage (Charnley C) is a factor which is conducive to difficulties. For patients, total hip replacement is associated with an improvement in sexual relations. The frequency of relations is increased in significantly more women than men, where this is associated with a change in positions practised. Only 17% of patients benefited from information concerning sexual activity after THA (time to resumption and/or at-risk positions).
Sexual difficulties should therefore be taken into account by medical staff, and in particular by the surgeon. He should supply clear information. The subject should not be marginalized and, on the contrary, should be taken into account in the pre- and postoperative assessment.
慢性髋部疼痛会对患者的性活动产生影响，对于年轻患者而言影响更大。
我们科室进行了一项回顾性研究，向135名65岁以下的患者（58名女性和77名男性）邮寄了调查问卷，这些患者在6个月前接受了初次植入的全髋关节置换术（THA）。患者的平均年龄为51.8岁（22 - 65岁）。
性困难首次出现的平均年龄为45岁（21 - 63岁），即髋部疼痛出现后平均2.5年。19%的患者认为他们的性困难严重至极。这给7%的患者的关系带来了紧张或不愉快。困难的原因通常是疼痛，其次是僵硬。最明显且最早出现障碍的患者是患有髋关节脱位异常的年轻女性。多关节损伤（Charnley C级）是导致困难的一个因素。对患者来说，全髋关节置换术与性关系的改善相关。性关系频率增加的女性明显多于男性，这与所采用的体位变化有关。只有17%的患者在全髋关节置换术后获得了有关性活动的信息（恢复时间和/或危险体位）。
因此，医务人员，尤其是外科医生，应考虑到性困难。他应提供明确的信息。这个问题不应被边缘化，相反，应在术前和术后评估中予以考虑。
