Hip arthroscopy and periacetabular osteotomy generally improve sexual function in patients, but have a risk of iatrogenic pudendal nerve injury that can temporarily worsen sexual function: A systematic review

IF 5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-05-19 DOI:10.1002/ksa.12700

Madeline Hubbard, Darya Pascarel, Prushoth Vivekanantha, Mahmoud Almasri, Shahbaz Malik, Amit Meena, Darren de SA

{"title":"Hip arthroscopy and periacetabular osteotomy generally improve sexual function in patients, but have a risk of iatrogenic pudendal nerve injury that can temporarily worsen sexual function: A systematic review","authors":"Madeline Hubbard, Darya Pascarel, Prushoth Vivekanantha, Mahmoud Almasri, Shahbaz Malik, Amit Meena, Darren de SA","doi":"10.1002/ksa.12700","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Purpose</h3>\n \n <p>To summarise how orthopaedic hip sports medicine procedures affect patients' sexual function so that surgeons can better counsel their patients on this topic.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Three databases (MEDLINE, EMBASE and PubMed) were searched on 27 April 2024 with search terms relating to sexual activity and orthopaedic procedures. The authors adhered to the PRISMA and R-AMSTAR guidelines and Cochrane Handbook for Systematic Reviews of Interventions.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seventeen studies with a total of 5976 patients (6275 joints) were included in this study. Hip arthroscopies were performed in 5812 patients for a total of 6087 surgeries, and 164 patients received 188 osteotomies. Nine of 17 studies reported iatrogenic nerve injury (103/1854; 5.6%), mainly of the pudendal nerve (64/103, 62.1%). All of male, female, and combined male and female sexual function tended to be compromised prior to hip sports medicine surgery and improved after surgery as per International Index of Erectile Function (IIEF) (<i>p</i> = 0.009) and Female Sexual Function Index (FSFI) (<i>p</i> < 0.001) scores. Improvements after surgery were largely due to decreased hip pain and stiffness during sexual activity. Return to sexual activity was reported to be 29.2 ± 20.1 days after hip arthroscopy. Only three studies discussed preoperative counselling on sexual activity.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Hip sports medicine surgeries can improve sexual function for patients; however, they have a risk of pudendal nerve damage that can temporarily interfere with sexual function. Surgeons should counsel their patients on the risks and benefits of hip sports orthopaedic surgeries to sexual function.</p>\n </section>\n \n <section>\n \n <h3> Level of Evidence</h3>\n \n <p>Level IV.</p>\n </section>\n </div>","PeriodicalId":17880,"journal":{"name":"Knee Surgery, Sports Traumatology, Arthroscopy","volume":"33 7","pages":"2642-2654"},"PeriodicalIF":5.0000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ksa.12700","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Knee Surgery, Sports Traumatology, Arthroscopy","FirstCategoryId":"3","ListUrlMain":"https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.12700","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

To summarise how orthopaedic hip sports medicine procedures affect patients' sexual function so that surgeons can better counsel their patients on this topic.

Methods

Three databases (MEDLINE, EMBASE and PubMed) were searched on 27 April 2024 with search terms relating to sexual activity and orthopaedic procedures. The authors adhered to the PRISMA and R-AMSTAR guidelines and Cochrane Handbook for Systematic Reviews of Interventions.

Results

Seventeen studies with a total of 5976 patients (6275 joints) were included in this study. Hip arthroscopies were performed in 5812 patients for a total of 6087 surgeries, and 164 patients received 188 osteotomies. Nine of 17 studies reported iatrogenic nerve injury (103/1854; 5.6%), mainly of the pudendal nerve (64/103, 62.1%). All of male, female, and combined male and female sexual function tended to be compromised prior to hip sports medicine surgery and improved after surgery as per International Index of Erectile Function (IIEF) (p = 0.009) and Female Sexual Function Index (FSFI) (p < 0.001) scores. Improvements after surgery were largely due to decreased hip pain and stiffness during sexual activity. Return to sexual activity was reported to be 29.2 ± 20.1 days after hip arthroscopy. Only three studies discussed preoperative counselling on sexual activity.

Conclusion

Hip sports medicine surgeries can improve sexual function for patients; however, they have a risk of pudendal nerve damage that can temporarily interfere with sexual function. Surgeons should counsel their patients on the risks and benefits of hip sports orthopaedic surgeries to sexual function.

Level of Evidence

Level IV.

Abstract Image

查看原文本刊更多论文

髋关节镜和髋臼周围截骨术通常能改善患者的性功能，但有医源性阴部神经损伤的风险，可使性功能暂时恶化：一项系统综述。

目的：总结骨科髋关节运动医学手术对患者性功能的影响，以便外科医生更好地就这一主题向患者提供建议。方法：于2024年4月27日检索MEDLINE、EMBASE和PubMed三个数据库，检索词与性行为和骨科手术相关。作者遵循PRISMA和R-AMSTAR指南和Cochrane干预措施系统评价手册。结果：17项研究共纳入5976例患者（6275个关节）。5812例患者行髋关节镜手术6087例，其中164例患者行188例截骨术。17项研究中有9项报道了医源性神经损伤(103/1854；5.6%)，主要是阴部神经（64/103,62.1%）。根据国际勃起功能指数（IIEF）（p = 0.009）和女性性功能指数（FSFI）（p = 0.009），所有男性、女性和男女合并的性功能在髋关节运动医学手术前均有下降趋势，术后均有改善趋势(p结论：髋关节运动医学手术可改善患者性功能；然而，他们有阴部神经损伤的风险，可能会暂时干扰性功能。外科医生应告知患者髋关节运动矫形手术对性功能的风险和益处。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).