Patient Expectations of Sexual Activity After Total Hip Arthroplasty: A Prospective Multicenter Cohort Study.

Autor:	Harmsen RTE; Departments of Biomedical Data Sciences (H.P.), Orthopaedics (R.T.E.H., C.S.L., and R.G.H.H.N.), and Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, Leiden, the Netherlands., den Oudsten BL; Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands., Putter H; Departments of Biomedical Data Sciences (H.P.), Orthopaedics (R.T.E.H., C.S.L., and R.G.H.H.N.), and Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, Leiden, the Netherlands., Leichtenberg CS; Departments of Biomedical Data Sciences (H.P.), Orthopaedics (R.T.E.H., C.S.L., and R.G.H.H.N.), and Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, Leiden, the Netherlands., Elzevier HW; Departments of Biomedical Data Sciences (H.P.), Orthopaedics (R.T.E.H., C.S.L., and R.G.H.H.N.), and Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, Leiden, the Netherlands., Nelissen RGHH; Departments of Biomedical Data Sciences (H.P.), Orthopaedics (R.T.E.H., C.S.L., and R.G.H.H.N.), and Urology and Medical Decision Making (H.W.E.), Leiden University Medical Center, Leiden, the Netherlands.
Jazyk:	angličtina
Zdroj:	JB & JS open access [JB JS Open Access] 2018 Oct 04; Vol. 3 (4), pp. e0031. Date of Electronic Publication: 2018 Oct 04 (Print Publication: 2018).
DOI:	10.2106/JBJS.OA.18.00031
Abstrakt:	Background: This study aimed to evaluate patients' expectations of postoperative sexual activity (SA) after total hip arthroplasty. Methods: A prospective multicenter cohort study of 1,271 patients managed with total hip arthroplasty was performed using patient-reported outcome measures of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis Study (LOAS). Preoperative SA expectations and their fulfillment after 1 year were assessed with the Hospital for Special Surgery expectations survey. The Hip disability and Osteoarthritis Outcome Score (HOOS) was used to measure functional status, and the Short Form-12 Mental and Physical Component Summary scores (SF-12 MCS and SF-12 PCS) and EuroQol-5 Dimensions (EQ-5D) questionnaire were used to measure health status. Two subgroups were defined preoperatively: the SA-Expecting Group and the No-SA-Expecting Group. The postoperative outcomes with regard to SA (i.e., the difference between postoperative and preoperative SA scores) were classified as "unfulfilled" (score, ≤-1), "fulfilled" (score, 0), or "exceeded" (score, ≥1). Multivariate regression analyses were used, with t tests to compare means between groups. Results: In total, 952 (74.9%) patients returned both preoperative and postoperative HSS questionnaires. Preoperatively, 605 patients (63.6%) expected to have postoperative SA. At 1 year, 43.5% of participants reported that this expectation was unfulfilled. In the No-SA-Expecting Group, 18.2% (63 of 347) regained SA, predominantly men. Postoperative SA fulfillment was related to preoperative musculoskeletal (p = 0.001) and non-musculoskeletal comorbidities (p = 0.004) and the postoperative HOOS, SF-12 PCS, SF-12 MCS, EQ-5D, and EQ-5D visual analog scale (VAS) scores (p < 0.001). Postoperative HOOS-symptoms (odds ratio [OR] 1.04; 95% confidence interval [CI], 1.02 to 1.06; p < 0.001), and HOOS-sport (OR, 1.01; 95% CI, 1.00 to 1.03; p = 0.032) were associated with postoperative SA fulfillment, as was older age (inversely; e.g., ≥76 years compared with ≤60 years: OR, 0.28; 95% CI, 0.13 to 0.62; p = 0.002). Correspondingly, for the No-SA-Expecting Group, higher age was also inversely associated with regaining postoperative SA (e.g., ≥76 years: OR, 0.07; 95% CI, 0.02 to 0.21; p < 0.001). Conclusions: Of the patients who expected to be sexually active after surgery, 43.5% perceived this expectation to be unfulfilled; 24.3% were still sexually inactive despite most having expected a return to normal SA. Approximately one-fifth of patients who did not expect postoperative SA in fact regained SA. During preoperative consultations, surgeons should pay attention to expectation management surrounding SA. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Databáze:	MEDLINE
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