title: Sexual Function before and after Total Hip Replacement: Narrative Review.
abstract: BACKGROUND
  More than 1 million total hip replacements (THRs) are performed every year worldwide. Achieving decreased pain, increased mobility, and improved quality of life (QoL) are key factors in the decision to undergo THR. Sexual activity is a valued component of QoL; however, little is known about how THR affects sexual functioning or the extent to which health care providers address sexuality in THR patients.
  
  
  OBJECTIVE
  The aim of the study was to assess the literature regarding sexuality and sexual function in patients before and after THR.
  
  
  METHODS
  PubMed, Google Scholar, and PEDro databases were searched without search limitations from inception until December 2013 for terms relating to sexual function and THR.
  
  
  RESULTS
  Sexual activity before and after a THR is an important QoL issue. In patients with end-stage hip osteoarthritis, THR has been reported to have beneficial effects in restoring sexual satisfaction and performance. While research has recently been conducted to determine the range of motion of the hip joints necessary to execute certain sexual positions, there remains a lack of validated guidelines and the risks related to sexual activity after THR is rarely discussed between patients and medical staff.
  
  
  CONCLUSIONS
  The ability to move comfortably is included among the many physical and psychosocial factors influencing sexual functioning. Practitioners should be encouraged to question their THR patients about sexual concerns and to provide counseling related to physical and functional aspects of sexual activity. Rehabilitation that focuses specifically on activities of daily living of sex should include sexual counseling, therapeutic exercise, and advice regarding sexual positions. Rehabilitation provided by physical therapists may help decrease pain, and facilitate greater self-awareness, self-confidence, and improved body image, all of which encourage and affirm optimal sexual health. Meiri R, Rosenbaum TY, and Kalichman L. Sexual function before and after total hip replacement: Narrative review.
authors.affiliation: Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Beer Sheva, Israel ; Physical Therapy Center, Meuhedet Health Services Rehovot, Israel.
authors.forename: Rotem
authors.initials: R
authors.lastname: Meiri
authors.affiliation: Inner Stability, Ltd. Individual and Couple's Sex Therapy Bet Shemesh, Israel.
authors.forename: Talli Y
authors.initials: TY
authors.lastname: Rosenbaum
authors.affiliation: Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev Beer Sheva, Israel.
authors.forename: Leonid
authors.initials: L
authors.lastname: Kalichman
keywords: End-Stage Hip Osteoarthritis; Quality of Life; Sexual Dysfunction; Total Hip Replacement