The impact of total hip arthroplasty on sexual satisfaction in female patients: a prospective before-and-after cohort study

Purpose: Despite the high rate of sexual limitation in female patients with hip osteoarthritis, evidence reporting sexual satisfaction after hip arthroplasty in women is limited. This study aimed to assess the impact of surgery on sexual satisfaction in women who undergo elective total hip arthroplasty (THA). As a secondary objective, we measured the effect of THA on different factors that could be related to sexual limitation and satisfaction. Methods: We designed a prospective before-and-after cohort study in which all consecutive women undergoing THA were screened for inclusion. Patients answered a ten question specifically designed questionnaire before and after surgery. An independent analysis was performed for each question through a McNemar-Bowker test for paired proportions. Results: Fifty-six patients completed the protocol and were available for analysis at the end of the study. Sexual satisfaction increased from 29% before surgery to 93% after the procedure (p < 0.001). All questions related to physical limitations demonstrated significant improvement after surgery. In addition, psychological aspects of limitation including fear of pain and injury, or perception of attractiveness, showed significant recovery as well. Conclusion: There is a high rate of patients reporting limitations and disabilities during sexual activities among women with osteoarthritis. THA represents a positive impact on sexual functioning both in its physical and psychological aspects, thus increasing satisfaction rates in female patients. Surgeons should include these elements in the conversation with patients before and after surgery.