长度不起作用 - 短柄全髋关节置换术后男性的性行为。
Length doesn't play a role - Sexual activity in men after short stem Total hip Arthroplasty.
机构信息
ARCUS Sportklinik, Rastatterstraße 17-19, 72175, Pforzheim, Germany.
Orthopädische Klinik Paulinenhilfe, Diakonieklinikum Stuttgart, Rosenbergstraße 38, 70176, Stuttgart, Germany.
出版信息
BMC Musculoskelet Disord. 2022 Jul 22;23(1):696. doi: 10.1186/s12891-022-05660-8.
BACKGROUND
Chronic hip pain due to osteoarthritis or hip dysplasia has been shown to negatively affect many daily life aspects. One aspect, however, which persists underestimated is sexual health. The number of total hip arthroplasties (THA) are increasing, especially in young patients who have high functional expectations, not only to pain relief, but to an increase in hip mobility and quality of life as well as sexual activity.
AIM
(1) to report the demographic factors, (2) the sexual activity before and after THA, as well as the concerns related to sexual activity after THA and (3) the patient-reported outcome measurements (PROMs) in sexually active male patients.
METHODS
We evaluated the results of patients between 18 and 65 years of age following primary cementless short femoral stem THA using a direct anterior approach (DAA) at a midterm follow-up of 4 years. A web-based questionnaire (via SurveyMonkey) was chosen to assess frequency, positions, complaints, fears, dealing with the questions and PROMs. Our patients sexual activity was via The Sexual Health Inventory for Men (SHIM) validated.
RESULTS
Patients resumed their sexual activities after 6 weeks. The two main causes of difficulty in sexual activity before surgery were pain and limitation of the range of motion of the hip joint. Patients experienced less pain and an improvement in hip range of motion after THA. 89% of patients expressed a desire for more detailed and specific information on the subject. The patients foremost concern about muscle weakness, surgical scar or fear of dislocation. After 4 years follow-up our patients presented a significant improvement of the modified Harris Hip Score (mHHS) from 34.1 preoperative to 92.6 after THA.
CONCLUSION
THA improves the quality in sexual life, in relation to less pain and improvement in the range of motion, but not in the frequency of sexual activity. Men's sexual positions required less mobility and could therefore be considered safer.
背景
髋关节炎或髋关节发育不良导致的慢性髋痛已被证明会对许多日常生活方面产生负面影响。然而，一个被低估的方面是性健康。全髋关节置换术（THA）的数量不断增加，尤其是在年轻患者中，他们对功能的期望很高，不仅希望缓解疼痛，还希望增加髋关节活动度和生活质量以及提高性生活质量。
目的
（1）报告人口统计学因素，（2）THA 前后的性生活，以及与 THA 后性生活相关的担忧，以及（3）活跃男性患者的患者报告结局测量（PROM）。
方法
我们评估了在中期随访 4 年后，使用直接前入路（DAA）进行初次非骨水泥短股骨柄 THA 的 18 至 65 岁患者的结果。选择基于网络的问卷（通过 SurveyMonkey）来评估频率、姿势、投诉、恐惧、处理问题和 PROM。我们的患者的性生活通过经过验证的男性性健康量表（SHIM）进行评估。
结果
患者在 6 周后恢复了性生活。手术前性生活困难的两个主要原因是疼痛和髋关节活动度受限。患者在 THA 后疼痛减轻，髋关节活动度改善。89%的患者表示希望获得更多关于该主题的详细和具体信息。患者最关心的是肌肉无力、手术疤痕或担心脱位。在 4 年随访后，我们的患者的改良 Harris 髋关节评分（mHHS）从术前的 34.1 分显著改善至 THA 后的 92.6 分。
结论
THA 改善了性生活质量，与疼痛减轻和活动度改善有关，但与性生活频率无关。男性的性姿势需要的活动度较小，因此可以认为更安全。
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