Changes in sexual activity of male patients with ankylosing spondylitis undergoing total hip arthroplasty.

INTRODUCTION: Sexual activity is often an important component of life. To date, no studies have examined sexual activity before and after total hip arthroplasty (THA) in male patients with ankylosing spondylitis (AS). The purpose of the current study was to evaluate the effect of THA on sexual activity and to explore the most commonly reported and comfortable coital position for male AS patients with hip involvement.

METHODS: Data from 31 male AS patients who underwent THA for hip involvement were retrospectively reviewed. Information from the International Index of Erectile Function (IIEF), the Harris Hip Score (HHS) and other clinical parameters was collected and monitored over time. We compared the above-mentioned parameters before surgery and 2 years after surgery and analysed the correlation between changes on the IIEF and changes in clinical parameters.

RESULTS: The domain and total scores of the IIEF, except EF, were significantly higher after surgery than were those before surgery ( p < 0.05). There was a significant positive correlation between changes on the IIEF and improvement in flexion-extension range of motion (ROM), adduction-abduction ROM and HHS ( p < 0.05). Most patients (26/31, 83.9%) resumed sexual activity 5-12 weeks after surgery. The pre- and postoperative distributions of the most commonly reported and comfortable position were not significantly different (p > 0.05).

CONCLUSIONS: Successful THA may improve sexual activity in male AS patients with hip involvement. Changes in hip ROM show the most significant correlation with improvement in sexual activity. Resumption of sexual activity occurs within 5-12 postoperative weeks.