title: Does total hip replacement affect sexual quality of life?
abstract: BACKGROUND
  Total Hip Replacement (THR) is an effective treatment for end-stage hip osteoarthritis. Since the introduction of total joint replacement, the effect on the Sexual Quality of Life (SQoL) following THR has been addressed in scant studies. The aim of our study was to systematically review the literature, to summarise effects of THR on patients' SQoL.
  
  
  METHODS
  We searched PubMed, EMBASE and PsycINFO between January 1970 and February 9th, 2015 with search terms including Total Hip, Osteoarthritis, SQoL, and THR. Eligible studies were identified and two independent authors extracted data including details of SQoL, study quality and risk of bias.
  
  
  RESULTS
  There were 12 eligible studies, which included a total of 2099 patients with an age range of 20-85 years. The methodological quality of ten studies was rated as low, and of two as moderate. Amongst the majority of patients, SQoL improved after surgery, both in terms of physical-functional and psychosocial well-being. However, changes between pre-operative and postoperative SQoL ranged extensively: for example, Sexual Dysfunction Δ 8-51% and Sexual Activity (SA) Δ 0-77%. Three studies reported that some patients never resumed SA again after surgery.
  
  
  CONCLUSIONS
  In over 40 years of THR treatment, scant studies have examined the effect of THR on patients' SQoL. This review suggests that SQol improves after THR, although the magnitude of effects varies highly. However, the quality of the supporting evidence was rated as low to moderate. This suggests a need for more high quality evidence about the effects of THR on SQoL.
authors.affiliation: Department of Orthopaedic Surgery, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 BT, The Netherlands.
authors.forename: Rita Th E
authors.initials: RT
authors.lastname: Harmsen
authors.affiliation: Department of Orthopaedic Surgery, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 BT, The Netherlands. t.haanstra@vumc.nl.
authors.forename: Tsjitske M
authors.initials: TM
authors.lastname: Haanstra
authors.affiliation: Department of Orthopaedic Research and the Linnaeus Research Institute, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Inger N
authors.initials: IN
authors.lastname: Sierevelt
authors.affiliation: Department of Medical Information and Library, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Elise P
authors.initials: EP
authors.lastname: Jansma
authors.affiliation: Department of Orthopaedic Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Nolte
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Melianthe P J
authors.initials: MP
authors.lastname: Nicolai
authors.affiliation: Department of Warwick Orthopaedics, University of Warwick, Coventry, UK.
authors.forename: Peter D H
authors.initials: PD
authors.lastname: Wall
authors.affiliation: Department of Orthopaedic Surgery, VU University Medical Center Amsterdam, De Boelelaan 1117, Amsterdam, 1081 BT, The Netherlands.
authors.forename: Barend J
authors.initials: BJ
authors.lastname: Van Royen
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000523:psychology* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000523:psychology* / Q000601:surgery*; D011788:Quality of Life / Q000523:psychology*; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology*
keywords: Hip (osteo)Arthritis; Sexual Quality of Life; Total Hip Replacement