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

  • Maryam Hakimi Abed1 | Behnoosh Vasaghi-Gharamaleki2 |
    Mohammad Taghi Ghazavi3 | Afsaneh Nikjooy1Abstract

    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

    ۳ 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 (±۴٫۶۵) and 8 women

    with a mean age of 72.75 years (±۷٫۳۲) 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.

    KEYWORDS

    International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), total hip

    arthroplasty, urinary incontinence, Western Ontario and McMaster Universities Osteoarthritis

    Index (WOMAC)

    Received: 9 June 2022 Revised: 3 October 2022 Accepted: 6 October 2022

    DOI: 10.1111/luts.12466

  • Lower Urinary Tract Symptoms. 2022;1–۵٫ wileyonlinelibrary.com/journal/luts © ۲۰۲۲ John Wiley & Sons Australia, Ltd

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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

۳ 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 (±۴٫۶۵) and 8 women

with a mean age of 72.75 years (±۷٫۳۲) 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.

KEYWORDS

International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), total hip

arthroplasty, urinary incontinence, Western Ontario and McMaster Universities Osteoarthritis

Index (WOMAC)

Received: 9 June 2022 Revised: 3 October 2022 Accepted: 6 October 2022

DOI: 10.1111/luts.12466

Lower Urinary Tract Symptoms. 2022;1–۵٫ wileyonlinelibrary.com/journal/luts © ۲۰۲۲ John Wiley & Sons Australia, Ltd