Patient sexual function and hip replacement surgery: A survey of surgeon attitudes

• Published in: International orthopaedics Vol. 41; no. 12; pp. 2433 - 2445
• Main Authors: Harmsen, Rita Th. E., Nicolai, Melianthe P. J., Den Oudsten, Brenda L., Putter, Hein, Haanstra, Tsjitske M., Nolte, Peter A., Van Royen, Barend J., Elzevier, Henk
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2017
• Subjects: Adult; Aged; Arthroplasty, Replacement, Hip - statistics & numerical data; Attitude of Health Personnel; Cross-Sectional Studies; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Paper; Orthopedic Surgeons - statistics & numerical data; Orthopedics; Osteoarthritis, Hip - surgery; Patients; Physician-Patient Relations; Practice Patterns, Physicians' - statistics & numerical data; Sexual Behavior - statistics & numerical data; Surveys and Questionnaires; Replacement hip; Arthroplasty; Physician-patient relations; Sexual (Dys)function; Osteoarthritis hip; Communication
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-017-3473-7

Purpose To explore practises of orthopaedic surgeons (and residents) in addressing sexual function (SF) in patients before and after total hip arthroplasty (THA). Methods A 26-item questionnaire was sent to health professionals ( n  = 849); 526 (62.0%) responses were included in the analyses. Results About 78% of the respondents (77.5%) almost never addressed SF. The most mentioned reason was that “patients do not ask” (47.4%) followed by “I am not aware of possible needs” (38.6%). SF was even less discussed (25.9%) in elderly patients (>60 years). The beneficial effect of THA on SF was rated the highest in retired surgeons ( p  ≤ 0.001), in which male surgeons scored higher than female surgeons ( p  = 0.002). The importance of sexual dificulties (SD) in the decision to undergo surgery was rated lowest by residents ( p  = 0.020). Rating the risk for dislocation varied between occupations ( p  = 0.008) and gender ( p  = 0.016), female surgeons rated highest (median 5); 54.1% indicated the orthopaedic surgeon is responsible for providing information about the safe resumption of sexual activity. Conclusions Surgeons show little attention to SF related issues in THA patients, which seems not in accordance to patients’ needs. Addressing SF increases throughout a surgeon’s career. There were divergent views and there is no “common advice” about the safe resumption of sexual activity. The results emphasize the need for guidelines and training in order to encourage addressing SF both, before and after THA.