Prevalence of Pelvic Floor Disorders and Impact of Surgery in Women with Hip Dysfunction

Objectives: To determine the prevalence of pelvic floor disorders (PFD) in females presenting for hip arthroscopy. We secondarily sought to determine whether there is a change in symptoms at 3 months following hip arthroplasty.

Methods: Women >18 years with clinical or radiographic diagnosis of hip dysfunction eligible for arthroscopic intervention planning hip arthroscopy with a single orthopedic surgeon were invited to complete surveys regarding pelvic floor symptoms and quality of life. Exclusion criteria included pregnancy and prior history of procedure for pelvic floor disorder including prolapse or incontinence. Participants completed surveys at baseline and 3 months post-hip arthroscopy. Surveys included the Pelvic Floor Disability Index (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), and Medical, Epidemiologic, and Social Aspects of Aging (MESA). Descriptive statistics were used to describe baseline pelvic floor prevalence. Wilcoxon signed rank test and McNemar’s Test were used to compare pre- and postoperative pelvic floor symptom and quality of life scores and symptom data.

Results: Fifty-nine participants completed baseline surveys; mean age was 39+14 years. The majority of participants were premenopausal (77%) and White (86%), and over one-half (56%) reported history of painful menses. Twenty-five percent (n=15) indicated some degree of bothersome pelvic floor symptoms at baseline, with a cohort median PFDI-20 score of 13.3 (IQR 3.5, 29.2) and PFIQ-7 of 0 (IQR 0,28.6). Fecal incontinence was reported by 6.8% (n=4). Urgency urinary incontinence was indicated by 8.5% (n=5) and stress urinary incontinence was indicated by 23.7% (n=14). Pelvic organ prolapse was reported by 7% (n=4). At 3 months post-arthroplasty, there were no significant changes in UI, FI, or POP symptom or quality of life scores. (Figure 1)

Conclusions: One in 4 women undergoing hip arthroplasty experienced a PFD. There was no significant difference in pelvic floor symptoms 3 months post-procedure, though study was limited by small sample size. Further investigation is needed to determine the impact of hip arthroscopy on pelvic floor symptoms.