Sexual function before and after primary total hip arthroplasty.

Objectives: Chronic hip pain can have an impact on the sexual activity of patients, all the more so if they are young.

Methods: 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).

Results: 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).

Conclusions: 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.