Thursday, March 28, 2024

Urinary Incontinence After Hip Replacement Surgery

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Question : Is Constipation After Surgery Normal

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Yes! Constipation is normal after any procedure and is often caused by anesthesia or certain medications. Plus, youre likely moving around less than you were before surgery. All these things can cause you to get a little backed up.

What can you do to get some relief? Make sure youre drinking plenty of fluids lots of water and eating foods with fiber, like vegetables and beans. Feel free to use a stool softener, too. Any over-the-counter product will do.

Also, remember that theres no set rule for how many bowel movements you should be having. If you had one every day before surgery, then thats your normal. However, some people have only three to four each week, and thats completely normal for them.

If your constipation doesnt ease up after at-home treatment, call your doctor.

Is Incontinence Normal After Knee Replacement

POUR was discovered in 46% of total knee replacement patients and 36% of patients during the study. For patients undergoing knee replacement, incontinence rates fell by 14%, and incontinence rates for total hip replacement patients fell by 2%.

Hip replacement surgery can be a life-changing procedure that results in significant improvements in quality of life within a short period of time. In the community, incontinence is most common among women over the age of 55, and it is most common among men over the age of 55. When other options for treatment have failed, hip replacement surgery is the only option. Hip replacement also carries a high risk of joint sepsis, which is inflammation of the joint. If this problem is not solved, it could result in bladder problems. You may experience temporary urination issues after surgery as a result of swelling. People with hypertension and prescription medications are more likely to develop incontinence.

Dont Worry Your Surgeon Has Heard Them All Here Are 5 Common Questions They Get

Youve just had hip replacement surgery congratulations! Youre well on your way to a more active tomorrow. But did you forget to ask a few burning questions at your last appointment? Not to worry we asked Dr. Michael Suk, chair of the Geisinger Musculoskeletal Institute and the Department of Orthopaedic Surgery, some of the most frequent questions they hear after hip replacements. So, you dont have to.

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Bladder Problems After Knee Replacement Surgery

Urine retention is defined as the inability to void urine even after having a full bladder. POUR is a common complication of hip and knee arthroplasty that causes the patient to urinate after the surgery. POUR causes permanent disability of detrusor function in infants who do not receive a POUR diagnosis until they are too old to play.

Considerations For Health Professionals With A Primary Role In Optimising Extra

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Urinary incontinence can have a significant impact on engagement with physical activity, socialisation, sleep quality, mental distress, and of course overall quality-of-life. This can add substantial burden to that already imposed by hip osteoarthritis or other hip conditions. Those presenting for treatment of hip conditions may not volunteer information on pelvic health, so its our role as health professionals to ask those extra questions. Working together with a Pelvic Health Professional may provide far more returns for the individual in your care.

  • Include those extra questions about pelvic health
  • Refer early to a pelvic health professional for assessment if you suspect a pelvic health component best to know early and work on both concurrently
  • Consider pelvic floor dysfunction as a contributor to persistent buttock or groin pain that does not appear to be responding as expected to an extra-pelvic treatment approach. Refer for an assessment to rule this contributor in or out
  • Consider that exercises for the hip may aggravate pelvic floor hypertonicity or overload a weakened pelvic floor e.g., some abdominal exercises, deep/loaded squats, sumo squats, split lunges, high activation buttock training banded squats, bridging, monster walks.

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Question : Will I Set Off Metal Detectors With My Joint Replacement

If your implant is made of metal, fully or partially, you may set off metal detectors at events, schools or airports. If youre somewhere that has a metal detector, let the person doing the screening know that you have a metal hip from joint replacement surgery.

They may still have you go through the metal detector, or they may offer you a separate, private screening or pat-down. Communicating that you may set off the metal detector and why is key to making sure the screening still goes smoothly so you can get to where youre going without incident.

Is It Normal To Pee A Lot After Hip Replacement Surgery

There is no definitive answer to this question as everyone experiences different levels of discomfort and pain after surgery. Some people may need to urinate more frequently due to the pain medication they are taking or the physical therapy they are undergoing. Others may have an increase in urinary frequency due to the surgery itself. If you are concerned about your urinary frequency, please consult with your surgeon.

If you urinate a lot frequently, you could be doing so with both a catheter and/or medication. You will not cure the condition until you have stopped taking medication if the drug is causing the problem. You should not let yourself become dehydrated because it could lead to other health issues. If you stop taking blood thinners, you will be able to return to normal as soon as possible. Maintain a patient demeanor and let the process work itself out. My doctor had told me I had prostate and hip problems at the same time. Thank you for joining our forum, and for sharing your valuable information.

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Hip Function In Those With Pelvic Floor Dysfunction

What do we know about hip function in those with pelvic floor dysfunction? Is there a relationship?

In a case-controlled study of 42 women , those with urgency or frequency were found to be significantly weaker in their hip abductors and external rotators on dynamometry than women without lower urinary tract symptoms. However, there were no between-group differences in pelvic floor strength or endurance measured via vaginal manometry .8 Similarly, Hartigan and colleagues found that women with stress urinary incontinence had lower hip external rotation and hip abduction strength than women without stress urinary incontinence.9 These differences were large in magnitude and likely clinically meaningful: hip abduction deficits of 40.9% and 32.1% and external rotator deficits of 15.9% and 18.0% in the group with stress urinary incontinence. They also found that there was no difference in pelvic floor muscle performance between the groups. Not that those with stress urinary incontinence had good pelvic floor muscle function, but that the control group had similar deficits. The majority of participants could not sustain a pelvic floor muscle contraction for 10 seconds and had power ratings of 3+ or less on internal assessment.9

The relationship between hip and pelvic floor muscle dysfunction is unclear.

Knee Replacement Surgery: The Good The Bad And The Ugly

Incontinence Can Negatively Impact Your Life

It is an extremely effective and life-saving procedure that relieves pain and discomfort. Post-operative incontinence affects 6% to 8% of men. Urinary tract infections are common after surgery, and they can lead to increased urination frequency. In addition to stiffness and difficulty with everyday activities, knee replacement surgery is frequently associated with other problems. A stiff knee joint is a difficult condition to manage after surgery. If any of these symptoms appear following surgery, you should consult your doctor.

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Drinking The Wrong Things At The Wrong Time

Staying hydrated is important for good overall health and wellbeing. But the more you drink, the more urine your body produces. If you have urinary incontinence, this will mean that you leak more urine.

Its therefore best to avoid or limit drinks that contain caffeine, as these have a greater diuretic effect. Caffeinated drinks include tea and coffee as well as cola and energy drinks.

Alcoholic beverages also have a diuretic effect, so try to limit your alcohol intake.

But avoiding too many fluids can also make your symptoms worse. Being dehydrated leads to dark, concentrated urine which can irritate the walls of the bladder, causing them to contract more often, and leak more urine.

Every person is unique, so try to balance your need to stay hydrated with how much fluid can make your urinary incontinence worse.

If urinary incontinence is a problem for you at night, its also best to avoid drinking too many fluids in the evening, and to avoid them completely just before bed.

Setting And Inclusion Criteria

The research team called upon orthopaedic units in university, regional, and local hospitals across Sweden. To avoid excess travel during data collections and enable participation in the intervention, the hospitals furthest north and south were contacted last. All 55 potential sites are equivalent in funding, either run by the public sector or company-driven hospitals with regional procurements. Further, they were considered equal, regardless of providing hip fracture surgery and elective hip replacements or elective hip replacement surgery only. A sample of 20 orthopaedic units was deemed necessary to provide sufficient statistical strength to detect an impending increase in adherence to the guidelines in the intervention group.

The sites were contacted by the research team with information and were engaged as a result of each head of department consenting to the OPTION study. Reasons for declining to participate concerned primarily staffing issues or heavy workload due to the pandemic .

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What Happens If You Do Too Much After Knee Replacement

When the bones surrounding the implant are subjected to too much activity, they may be loosening or fracturing. Too much movement can also cause swelling around the knee, slowing down the rehabilitation process, and making exercise more difficult.

What not to do if your knee has a torn ACL or a tornLCL. A patient can recover from the surgery in six months to a year. You should avoid sitting in a soft or low chair. It is not uncommon to feel significant pressure on your legs when you sit in low-back chairs, soft couches, stools, rocking chairs, or low-seat cars. You may be able to run or jog after knee surgery, but you will need months of intense fitness training to strengthen your muscles to protect your knees. Heavy lifting places strain on the joints, so do not lift anything more than a coffee cup. Wear flat shoes that donât slip, twist, or pivot if you have a tight leg.

When skiing is in good, powdery conditions, it is recommended that you resume your skiing slowly and gradually. High-impact sports, such as hockey, soccer, football, basketball, and tennis, put strain on the knees, resulting in knee pain. Consider swimming, cycling, golfing, kayaking, and scuba diving as low-impact sports that do not put strain on your new knee.

Causes Of Incontinence After Hip Replacement Surgery

4 Causes of Incontinence after Hip Replacement Surgery

Hip replacement surgery can change lives in a positive way, increasing quality of life. However, incontinence is an unwelcome side effect for many.

Hip replacement surgery is rapidly becoming more common and more advanced. Whilst they used to be a rare operation, they are now operated frequently.

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Loosening Of The Joint

This happens in up to 5 in 100 hip replacements. It can cause pain and a feeling that the joint is unstable.

Joint loosening can be caused by the shaft of the implant becoming loose in the hollow of the thigh bone , or due to thinning of the bone around the implant.

It can happen at any time, but it usually happens 10 to 15 years after the original surgery was done.

Another operation may be necessary, although this cannot be done in all patients.

Recovery Time For Often Peeing After Hip Replacement

You need to give yourself some time days after surgery. While for some patients, it takes a few hours after surgery to resolve their urinary incontinence.

It might take a couple of weeks or even a month for others before they could get control over their bladder situation.

We can see the additional factors are also responsible here, including bed rest, medications, and nerves affected.

If these factors are responsible for your urinary incontinence, youll see the effects wearing off once you regain mobility and are off the medications.

Till then, you can use a portable commode if its a long walk to the nearest bathroom to avoid any accidents. Doctors recommend rehabilitation and physical therapy days after surgery once they see youre ready.

Pelvic floor exercises or Kegel exercises help strengthen the urinary sphincter and pelvic floor muscles, which help control urination.

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Pelvic Floor Capacity Can The Pelvic Floor Go It Alone

No person is an island. The pelvic floor is not a little island state within the pelvis – it has important connections to the outside world that exists in the extra-pelvic environment. Compared with other skeletal muscles, the pelvic floor musculature is relatively thin, with small physiological cross-sectional area – the predictor of force generation.1 For example, the lumbar multifidus has a mean PCSA of 23.9 cm2, which is more than 30 times the PCSA of the pelvic floor muscles. While the healthy pelvic floor has the capacity to resist intra-abdominal pressure exerted by low load activities of daily living, such as standing and sitting, these muscles alone are unable to generate enough tension to withstand forces imposed by more challenging tasks such as a voluntary cough, a weighted squat or jumping.1 The additional support to meet these higher demands is proposed to come from non-contractile connective tissue elements, fascial attachments and extra-pelvic muscle attachments, primarily contributions from the obturator internus muscle.1

Training Effects Of Hip Muscle Strengthening On Pelvic Floor Muscle Function

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Tuttle and colleagues investigated the training effects of external rotator strengthening pelvic floor muscle force.7 Forty healthy nulliparous women, aged 18 to 35 years, were randomly assigned to either an exercise group or a control group. The exercise group performed hip external rotator strengthening 3 days/week for 12 weeks in sidelying and standing. Pelvic floor force production, as measured by a Peritron perineometer increased by almost 50% after this training period, and external rotator strength increased by around 20%.7 The mechanism underlying the changes in pelvic floor strength cannot be clearly determined. Did strength increase due to improved strength of the obturator internus muscle? There were of course other muscles working during these exercises, with high likelihood of pelvic floor muscle co-activation, but this was not measured. Participants were not instructed to co-contract their pelvic floor muscle, but automatic co-contraction particularly with weightbearing exercise is likely to have occurred. It was also not possible to blind participants to the fact that pelvic floor muscle function was a key interest of this study.

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Question : When Can I Get Intimate With My Partner Again After Surgery

Before your surgery, you may have been experiencing limited mobility and hip pain. But once you are completely healed, youll notice your mobility has increased and youll experience less pain.

You can resume intimacy with your partner as soon as youre ready with one catch. Youll know what your body can do, but youll want to avoid any sexual activity for at least two to three weeks after surgery to let everything heal.

Generally speaking, after having hip surgery youll want to avoid bending your hip joint more than 90 degrees in any activity , as well as avoiding rotating your leg too much in either direction. This will protect your hip joint while it continues to heal. Avoid the temptation to try anything new and stick to the basics. Call your doctor if you have any questions or experience any new pain afterwards.

At the end of the day, remember to listen to your body. If you feel good enough to travel, youre likely good to go. If you have any questions, just call your doctor. Theyll always be able to point you in the right direction!

The Effect Of Hip Osteoarthritis And Hip Replacement On Pelvic Floor Dysfunction

It seems that those with lower urinary tract conditions may have dysfunction of their hip musculature. So, do those with hip conditions have lower urinary tract symptoms and does treatment for hip conditions alter these symptoms?

There is little evidence available on prevalence of pelvic floor dysfunction and lower urinary tract symptoms in those with hip osteoarthritis, but the information that is available suggests that this is likely to be a common problem, at least for females . Tamaki and colleagues reported 41% of females in their prospective study of patients presenting for total hip arthroplasty reported symptoms of urinary incontinence.13 Another recent prospective study reported a similar prevalence of 38% of women presenting for total hip arthroplasty who had symptoms of urinary incontinence, defined as a score of 1 on the International Consultation on Incontinence QuestionnaireShort Form .14

Both papers suggested that there may be a link between urinary incontinence and hip osteoarthritis, mediated by atrophy of the obturator internus muscle, which is common in those with hip OA, and a change in position of the hip joint. A more externally rotated position of the hip may reduce tension in the obturator internus, thus reducing its ability to assist in force transfer of the levator ani muscles.

How exactly does hip arthroplasty improve urinary incontinence?

Key Learnings:

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Hip Replacement: The Day Of Surgery

Morning of surgery

Report to the outpatient surgery area of the hospital at the time designated on your surgery checklist. A nurse will review your medical history.

  • Take only the medications your health care provider tells you to take.

  • After you are admitted to the hospital, your temperature, pulse, respiration rate and blood pressure will be checked.

  • Your surgeon or another health care provider will write your surgeon’s initials on the hip to be operated on. This safety measure ensures that everyone in the operating room knows which hip is to be replaced. If you are not sure which hip will be replaced, ask your health care provider.

  • Support stockings or a compression device may be placed on the leg that will not be operated on. This is to promote blood circulation and lower the risk of blood clots.

  • An intravenous line may be started to give you fluid and medication through a vein.

  • You will meet the anesthesiologist, and he/she will discuss the type of anesthesia to be used. There are two options: A spinal anesthetic, which numbs you from the waist down. Sedation will also be given with a spinal, so you won’t hear the sounds of surgery. The other form is a general anesthetic, which involves a breathing tube placed through your mouth.

  • You will be dressed in a hospital gown, and an IV will be started in your arm. You will receive a preop dose of antibiotics. Your family/friends may wait with you, until you are taken to the Operating Room.

  • Additional Resources

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