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St. Paul’s Hospital Let’s Talk about SEX!

St. Paul’s Hospital Let’s Talk about SEX!

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St. Paul’s Hospital Let’s Talk about SEX!

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  1. St. Paul’s HospitalLet’s Talk about SEX! Mary Cho OT Michelle Bech NP(A)

  2. St. Paul’s Hospital Team

  3. Lets talk about SEXsince no one else will Do you talk to your arthroplasty patients about safe sexual positions after surgery?

  4. 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.

  5. 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)

  6. Lets talk about SEX since no one else will A survey of orthopaedic surgeons was done in 2004 The following questions were asked…

  7. QUESTION: Who asked more often about sex after THA RESULTS: MEN Lets talk about SEX since no one else will

  8. 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

  9. 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

  10. 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

  11. 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”

  12. 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.

  13. Lets talk about SEX since no one else will • Are you aware of any dislocations during sexual activity? 2 -“NO” 1 - “YES”

  14. 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

  15. 4 recommended positions for men with THA • Men on the top • More than 90% of the surgeons recommended these positions

  16. Recommended positions for men with THA(men on bottom)

  17. 2 recommended positions for women with THA • Women on the bottom • More than 90% of the surgeons recommended these positions

  18. Recommended positions men and women with THAs • Considered acceptable by greater than 90% of physicians when both individuals have had THAs

  19. 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.

  20. 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

  21. Approved Positions

  22. Positions to avoid

  23. Patient information available

  24. IDEAS? • How to bring it up. • When to bring it up • Who to bring it up with

  25. THANKS!!

  26. 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