title: Prospective analyses of female urinary incontinence symptoms following total hip arthroplasty.
abstract: OBJECTIVE
  Some patients with hip osteoarthritis report that urinary incontinence (UI) is improved following total hip arthroplasty (THA). However, the type and severity of UI remain unclear. In this study, we hypothesize that both stress urinary incontinence (SUI) and urge urinary incontinence (UUI) are improved after THA. We assess the characteristics of UI and discuss the anatomical factors related to UI and THA for improved treatment outcome.
  
  
  METHODS
  Fifty patients with UI who underwent direct anterior-approach THA were evaluated. Type of UI was assessed using four questionnaires: Core Lower Urinary Tract Symptom Score (CLSS), Urogenital Distress Inventory Short Form (UDI-6), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Uroflowmetry and postvoid residual urine were measured using ultrasound technology. Hip-joint function was evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM).
  
  
  RESULTS
  Of the 50 patients, 21 had SUI, 16 had mixed urinary incontinence (MUI), and eight had urgency urinary incontinence (UUI). In total, 36 patients were better than improved (72 %). The rate of cured and improved was 76 % for SUI, 100 % MUI, and 50 % UUI. The improvement of ROM was more significant in cured or improved patients than in stable or worse patients.
  
  
  CONCLUSIONS
  Improvement in mild UI may be an added benefit for those undergoing THA for hip-joint disorders. These data suggest that for patients with hip-joint disorder, hip-joint treatment could prove to also be a useful treatment for UI.
authors.affiliation: Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan.|Department of Urology, Tosei General Hospital, Aichi, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Okumura
authors.affiliation: Institute of Education, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Joint Replacement Center, Funabashi Orthopedic Hospital, Funabashi, Chiba, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tamaki
authors.affiliation: Joint Replacement Center, Funabashi Orthopedic Hospital, Funabashi, Chiba, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Oinuma
authors.affiliation: Department of Pelvic Reconstructive Surgery, Urology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Tomoe
authors.affiliation: Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan. akita.fana@tmd.ac.jp.
authors.forename: Keiichi
authors.identifier: http://orcid.org/0000-0002-2927-2937
authors.initials: K
authors.lastname: Akita
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Core lower urinary tract symptom score; Female urinary incontinence; Hip joint disorder; Total hip arthroplasty