Hip dysfunction-related urinary incontinence and total hip arthroplasty with the direct lateral approach

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY LUTS: Lower Urinary Tract Symptoms Pub Date : 2022-10-27 DOI:10.1111/luts.12466

Maryam Hakimi Abed, Behnoosh Vasaghi-Gharamaleki, Mohammad Taghi Ghazavi, Afsaneh Nikjooy

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Abstract

Objectives

There is a functional relationship between the hip joint and the pelvic floor muscles. In patients with secondary osteoarthritis of the hip, urinary incontinence is also seen. Research has shown that total hip arthroplasty (THA) surgery improves the symptoms of urinary incontinence. This prospective cross-sectional study without a control group was performed on THA candidates with urinary incontinence and secondary osteoarthritis with the aim of investigating the effect of THA with a direct lateral approach and subsequent routine physiotherapy on the symptoms of urinary incontinence.

Methods

Sampling was performed using a simple method among those referred to orthopedic clinics in the private sector. Data were collected in all patients before and 3 months after THA using demographic, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and hip range of motion record tables. The results are presented as mean with standard deviation.

Results

In this study, 16 men with a mean age of 76.75 years (±4.65) and 8 women with a mean age of 72.75 years (±7.32) participated. Before THA, stress urinary incontinence (54.16%) and urgency urinary incontinence (20.83%) had the highest frequency. However, after THA, the frequency of stress and urgency urinary incontinence decreased (16.66% and 8.33%, respectively). According to the results of the ICIQ, complete improvement of urinary incontinence symptoms was observed in up to 62.5% of the subjects. After THA, there was a significant difference between the mean total score obtained from the WOMAC questionnaire compared to before surgery. There was a significant improvement in the range of motion of the hip joint in all directions.

Conclusions

THA and routine hip physiotherapy in patients with urinary incontinence and secondary hip osteoarthritis have a significant positive effect on improving symptoms of urinary incontinence and hip function. In addition, it significantly improves the ICIQ and WOMAC questionnaire scores.

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髋关节功能障碍相关性尿失禁与直接外侧入路全髋关节置换术

目的研究髋关节与骨盆底肌肉之间的功能关系。继发性髋关节骨关节炎患者也会出现尿失禁。研究表明，全髋关节置换术可以改善尿失禁的症状。这项前瞻性横断面研究在没有对照组的情况下，对尿失禁和继发性骨关节炎的THA患者进行了研究，目的是研究THA直接侧位入路和随后的常规物理治疗对尿失禁症状的影响。方法采用简单的方法对到民营骨科就诊的患者进行抽样调查。所有患者在THA前和THA后3个月的数据收集采用人口统计学、国际失禁咨询问卷简表(ICIQ-SF)、安大略省西部和麦克马斯特大学骨关节炎指数(WOMAC)和髋关节活动范围记录表。结果以平均值和标准差表示。结果男性16例，平均年龄76.75岁(±4.65岁)，女性8例，平均年龄72.75岁(±7.32岁)。术前以压力性尿失禁(54.16%)和急迫性尿失禁(20.83%)发生率最高。但THA术后应激性尿失禁和急迫性尿失禁发生率分别下降了16.66%和8.33%。根据ICIQ的结果，高达62.5%的受试者尿失禁症状完全改善。THA后，WOMAC问卷平均总分与术前比较差异有统计学意义。髋关节在各个方向的活动范围都有显著的改善。结论THA联合常规髋关节物理治疗对尿失禁伴继发性髋关节骨关节炎患者的尿失禁症状和髋关节功能的改善有显著的积极作用。此外，还显著提高了ICIQ和WOMAC问卷得分。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.