Alkan Hilmi, Erdoğan Yasin, Veizi Enejd, Sezgin Başak Sinem, Çepni Şahin, Mert Halil Çağatay, Fırat Ahmet
Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey.
Department of Orthopedics and Traumatology, Ankara City Hospital, 06000 Ankara, Turkey.
Orthop Traumatol Surg Res. 2025 May;111(3):103693. doi: 10.1016/j.otsr.2023.103693. Epub 2023 Sep 29.
Femoro-acetabular impingement syndrome (FAIS) is a common cause of hip pain and functional decline. The quality of life of affected patients has been shown to be significantly diminished, with potential alterations in the ability to perform activities of daily living and recreation, including sexual function. Hip arthroscopy is the surgical technique recognized as the gold standard in FAIS. The aim of this study was to research the relationship between hip arthroscopy due to FAIS and pre- and postoperative sexual function.
The hypothesis of the study was that sexual dysfunction would be common during the preoperative period but would significantly improve after surgery.
This retrospective study included 96 patients aged 18 to 55 years, who underwent hip arthroscopy for a FAIS diagnosis between 2015 and 2021, with a minimum follow-up of one year. Exclusion criteria were a bilateral symptomatic hip condition, history of ipsilateral hip or knee surgery, history of urological or gynecological conditions, sexual dysfunction, or a history of hip osteonecrosis or osteoarthritis. The Female Sexual Function Scale (FSFI) was used to evaluate sexual dysfunction in females and the International Erectile Function Index (IIEF-5) for males.
The patients comprised 56.3% males and 43.82% females with a mean age of 35.3±8.3 years. Sexual dysfunction was determined preoperatively in 85.2% of the males and in 57.1% of the females. Overall improvement after surgery was statistically significant. Signs of pudendal nerve damage were seen during the postoperative period in 29 (30.2%) patients. The change in total sexual scores was significantly correlated with nerve symptoms and regression analysis showed that traction time was a significant risk factor for pudendal nerve symptoms.
Sexual dysfunction is a common trait of patients suffering from FAIS and the majority of patients significantly benefit from the procedure. Sexual dysfunction persists in a category of patients during the postoperative period, regardless of the type of lesion, and this phenomenon is associated with transient pudendal nerve symptoms, which are more likely to occur with longer traction times and thus represent a clear risk factor.
IV.
股骨髋臼撞击综合征（FAIS）是髋关节疼痛和功能下降的常见原因。已表明受影响患者的生活质量显著下降，在进行包括性功能在内的日常生活和娱乐活动的能力方面可能存在改变。髋关节镜检查是被公认为FAIS治疗金标准的手术技术。本研究的目的是探讨因FAIS接受髋关节镜手术与术前、术后性功能之间的关系。
本研究的假设是性功能障碍在术前很常见，但术后会显著改善。
这项回顾性研究纳入了96例年龄在18至55岁之间的患者，他们在2015年至2021年间因FAIS诊断接受了髋关节镜手术，且至少随访一年。排除标准包括双侧有症状的髋关节疾病、同侧髋关节或膝关节手术史、泌尿系统或妇科疾病史、性功能障碍、髋关节骨坏死或骨关节炎病史。女性性功能量表（FSFI）用于评估女性性功能障碍，男性国际勃起功能指数（IIEF-5）用于评估男性性功能障碍。
患者中男性占56.3%，女性占43.82%，平均年龄为35.3±8.3岁。术前确定85.2%的男性和57.1%的女性存在性功能障碍。术后总体改善具有统计学意义。术后有29例（30.2%）患者出现阴部神经损伤迹象。总性功能评分的变化与神经症状显著相关，回归分析表明牵引时间是阴部神经症状的显著危险因素。
性功能障碍是FAIS患者的常见特征，大多数患者从该手术中显著受益。无论病变类型如何，一类患者在术后性功能障碍仍然存在，这种现象与短暂的阴部神经症状相关，牵引时间越长越容易出现，因此是一个明确的危险因素。
IV级
