Does total joint arthroplasty impair erectile function?

Introduction: Sexuality is an important factor in quality of life (QoL) and was reported to improve after total joint arthroplasty (TJA). However, one study group found evidence regarding a high rate of impaired erectile function of about 20% in male patients after TJA. As erectile dysfunction is a serious matter of concern and there are no data explaining this observation sufficiently, the purpose of this study was to revaluate the erectile function in patients after TJA.

Material and methods: All consecutive male patients scheduled for TJA were enrolled in this prospective study. Evaluation was performed pre- and 6 months postoperatively with the International Index of Erectile Function (IIEF-5) questionnaire. One hundred and fifty-nine patients fulfilled the inclusion criteria, and 51 patients wished not to take part in the study.

Results: From the 108 patients who were included prior to surgery, 101 (94%) were available at the 6-month follow-up. In those patients, the preoperative erectile function was normal in 38 (24.0 ±1.1), impaired in 45 (14.7 ±6.5) and with no function in 18 patients. No significant difference in the pre- (15.4 ±9.3) and postoperative (15.3±9.2) IIEF-5 score was observed ( p = 0.59) in the total group. Similarly, subgroup analysis revealed no significant difference in patients with total hip arthroplasty ( p = 0.58), total knee arthroplasty ( p = 0.37) or > 70 years ( p = 0.08).

Conclusions: The previously reported high rate of impaired erectile function after TJA of the lower extremity could not be confirmed. Total joint arthroplasty remains a safe procedure in terms of postoperative erectile function.