Urinary Incontinence in Men and Women After Total Hip Arthroplasty: A Retrospective Observational Cohort Study

Mitchell Wolden; Samantha Khanna; Cameron New; Corrina Moore; Marie K March; Edward Graham; Bijoy Thomas; Gregory C Gass; Nick Vertzyas; Sean F Mungovan

doi:10.7759/cureus.82590

Urinary Incontinence in Men and Women After Total Hip Arthroplasty: A Retrospective Observational Cohort Study

Cureus. 2025 Apr 19;17(4):e82590. doi: 10.7759/cureus.82590. eCollection 2025 Apr.

Authors

Mitchell Wolden^{1

2}, Samantha Khanna³, Cameron New³, Corrina Moore³, Marie K March⁴, Edward Graham³, Bijoy Thomas³, Gregory C Gass², Nick Vertzyas^{4

5}, Sean F Mungovan^{2

3

6}

Affiliations

¹ Physical Therapy Program, University of Jamestown, Fargo, USA.
² Department of Orthopaedics, The Clinical Research Institute, Westmead, AUS.
³ Department of Orthopaedics, Westmead Private Hospital, Westmead, AUS.
⁴ Department of Orthopaedic Surgery, St. Vincent's Private Hospital, Sydney, AUS.
⁵ School of Medicine, University of Notre Dame, Sydney, AUS.
⁶ School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology (RMIT) University, Melbourne, AUS.

Abstract

Background: Our understanding of improved urinary incontinence (UI) following total hip arthroplasty (THA) is incomplete. Accordingly, our aim was to investigate the association between THA (anterior and posterior approach) on UI (stress, urge, and mixed urge/stress) in older women and men presenting with UI prior to THA.

Methods: A retrospective review of 318 consecutive patients who underwent primary unilateral THA in an acute surgical hospital was undertaken. Pre- and postoperative continence status was assessed using the International Consultation of Incontinence Questionnaire Urinary Incontinence (ICIQ-UI) Short Form (ICIQ-SF).

Results: Of the 288 patients included in our study, 120 patients had preoperative UI (Incontinent Group) and 168 were continent preoperatively (Continent Group). Postoperatively, 101 patients in the Incontinent Group and 114 patients in the Continent Group completed the ICIQ-SF. Following THA, patients in the Incontinent Group had significant changes in ICIQ-SF total scores (MD=1.7; 95% CI=0.93-2.56; p<0.01), frequency scores (MD=0.7; 95% CI=0.46-0.94; p<0.01), and severity scores (MD=0.6; 95% CI=0.31-0.84; p<0.01) and a non-significant decrease in the ICIQ-SF quality of life scores (MD=0.5; 95% CI=-0.10-1.03; p<0.01). Patients' sex (p=0.94), THA surgical approach (p=0.62), and the type of UI (p=0.61) had no significant effect on postoperative ICIQ-SF total scores. There was a non-significant relationship between age (r=0.03; p=0.79) and time to postoperative follow-up visit (r=-0.11; p=0.27) with ICIQ-SF total scores. In the Continent Group, 11 patients (9.6%) had postoperative UI.

Conclusions: For women and men with UI prior to THA, there was a significant postoperative improvement in UI, independent of sex or surgical approach. Including UI assessment and clinical management strategies into the pre- and postoperative care of women and men undergoing THA procedures is indicated.

Keywords: hips; total hip arthroplasty (tha); total joint arthroplasty; urinary incontinence (ui); urinary tract function.