Tamaki Tatsuya, Oinuma Kazuhiro, Shiratsuchi Hideaki, Akita Keiichi, Iida Satoshi
Joint Replacement Center, Funabashi Orthopedic Hospital, Funabashi, Chiba; Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University, Tokyo.
Int J Urol. 2014 Jul;21(7):729-31. doi: 10.1111/iju.12404. Epub 2014 Mar 4.
Patients reporting that their symptoms of urinary incontinence have decreased after total hip arthroplasty can be encountered in orthopedic practice. In this questionnaire-based study, we prospectively evaluated the symptoms of urinary incontinence before and after total hip arthroplasty. The International Consultation on Incontinence Questionnaire-Short Form was used to prospectively evaluate these symptoms in 189 consecutive female patients undergoing total hip arthroplasty. The patients were asked to fill in a questionnaire before and 3 months after surgery. A decrease in the International Consultation on Incontinence Questionnaire-Short Form score of ≥1 point was defined as an improvement, whereas an increase of ≥1 point was defined as worsening. A total of 81 (43%) patients reported urinary incontinence before total hip arthroplasty. At 3 months after surgery, symptoms of urinary incontinence were improved in 64% of these patients, remained unchanged in 32% and worsened in 4%. Mean International Consultation on Incontinence Questionnaire-Short Form score in patients with urinary incontinence before surgery significantly improved from 6.0 to 3.5 (P = 0.0002). These findings suggest a relationship between hip joint function and pelvic floor function, and consequently a hip dysfunction-related urinary incontinence.
在骨科临床实践中，会遇到一些患者称其在全髋关节置换术后尿失禁症状有所减轻。在这项基于问卷调查的研究中，我们对全髋关节置换术前、后的尿失禁症状进行了前瞻性评估。采用国际尿失禁咨询委员会简表，对189例连续接受全髋关节置换术的女性患者的这些症状进行前瞻性评估。患者在手术前和术后3个月被要求填写一份问卷。国际尿失禁咨询委员会简表评分下降≥1分被定义为改善，而评分增加≥1分被定义为恶化。共有81例（43%）患者在全髋关节置换术前报告有尿失禁。术后3个月时，这些患者中64%的尿失禁症状得到改善，32%保持不变，4%恶化。术前有尿失禁的患者，国际尿失禁咨询委员会简表平均评分从6.0显著改善至3.5（P = 0.0002）。这些发现提示髋关节功能与盆底功能之间存在关联，进而提示存在与髋关节功能障碍相关的尿失禁。
