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St. Paul’s Hospital Let’s Talk about SEX!. Mary Cho OT Michelle Bech NP(A). St. Paul’s Hospital Team. Lets talk about SEX since no one else will. Do you talk to your arthroplasty patients about safe sexual positions after surgery?. Lets talk about SEX since no one else will.

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st paul s hospital let s talk about sex

St. Paul’s HospitalLet’s Talk about SEX!

Mary Cho OT

Michelle Bech NP(A)

lets talk about sex since no one else will
Lets talk about SEXsince no one else will

Do you talk to your arthroplasty patients about safe sexual positions after surgery?

lets talk about sex since no one else will5
Lets talk about SEXsince no one else will

In a survey done by Stern SH et al. (1991) found 89% of patients desired more information regarding sexual activity after arthroplasty.

lets talk about sex
Lets talk about SEX

BC Orthopedic Hip and Knee Assessment Tool Version 1.0 asks about…

Other functional limitations (eg – putting on shoes, managing stairs, sitting to standing, sexual activity, bathing, cooking, recreation or hobbies)

lets talk about sex since no one else will7
Lets talk about SEX since no one else will

A survey of orthopaedic surgeons

was done in 2004

The following questions were asked…

lets talk about sex since no one else will8
QUESTION:

Who asked more often about sex after THA

RESULTS:

MEN

Lets talk about SEX since no one else will
lets talk about sex since no one else will9
QUESTION:

How frequently did the surgeon or a member of their team discuss sex after THA with their patients

RESULTS:

More than 80% of the respondents stated they rarely or never discussed it.

96% stated they spent 5 minutes or less in discussion

Lets talk about SEX since no one else will
lets talk about sex since no one else will10
QUESTION:

Are you aware of at least one patient who had a hip dislocation during sexual activity

RESULTS:

20% of the surgeons were aware of a dislocation

Lets talk about SEX since no one else will
lets talk about sex since no one else will11
QUESTION:

When can patients return to sexual activity after THA

RESULTS:

67% of respondents recommended delay of sexual activity until 1-3 months post-operatively with acceptable positions

Lets talk about SEX since no one else will
lets talk about sex since no one else will12
Lets talk about SEX since no one else will

We surveyed the 3 orthopedic surgeons at SPH …

  • When is it ok to resume sexual activity?

All 3 said – “When comfortable and whatever position is comfortable”

lets talk about sex since no one else will13
Lets talk about SEX since no one else will
  • How often do you discuss safe sexual positions with your patients post THA?

Very rarely…only if they bring it up.

lets talk about sex since no one else will14
Lets talk about SEX since no one else will
  • Are you aware of any dislocations during sexual activity?

2 -“NO”

1 - “YES”

lets talk about sex since no one else will15
Lets talk about SEX since no one else will
  • Sketches of 12 common sexual positions were provided to the American surgeons and they were asked to deem each position as either acceptable or unacceptable in a patient of each gender after THA
4 recommended positions for men with tha
4 recommended positions for men with THA
  • Men on the top
  • More than 90% of the surgeons recommended these positions
2 recommended positions for women with tha
2 recommended positions for women with THA
  • Women on the bottom
  • More than 90% of the surgeons recommended these positions
recommended positions men and women with thas
Recommended positions men and women with THAs
  • Considered acceptable by greater than 90% of physicians when both individuals have had THAs
recommended positions for tka
Recommended positions for TKA

Bottom position

Usually the most comfortable position

1-2 pillows may be placed under affected knee for comfort, bend the knee as comfort allows

Side-lying position

Use this position on the unaffected leg immediately after surgery

Pillows may be used under the knee to support the affected leg and increase comfort.

patient information available
Patient information available

Limited information available on the web

Approved Positions:

http://aboutjoints.com/patientinfo/topics/sexualconcerns/approvedpositions.html

Positions to avoid:

http://aboutjoints.com/patientinfo/topics/sexualconcerns/avoidpositions.html

ideas
IDEAS?
  • How to bring it up.
  • When to bring it up
  • Who to bring it up with
references
References
  • Dahm, DL, Jacofsky, D, and Lewallen, D.G. Surgeons Rarely Discuss Sexual Activity with Patients after THA. Clinical Orthopaedics and Related Research428: 237-240, 2004.
  • Stern SH, Fuchs MD, Ganz SB, et al: Sexual function after total hip arthroplasty. Clinical Orthopedic 269: 228-235, 1991.
  • http://aboutjoints.com/patientinfo/topics/sexualconcerns/approvedpositions.htm
  • http://aboutjoints.com/patientinfo/topics/sexualconcerns/avoidpositions.html