Postoperative activity restrictions after slings: A randomized controlled trial
Recommended Citation
Lai E, McDonald K, Chopra V, et al. Postoperative Activity Restrictions After Slings: A Randomized Controlled Trial. Urogynecology (Phila). Published online May 6, 2024. doi:10.1097/SPV.0000000000001515
Abstract
Importance:Restricting activity after midurethral slings is an unproven practice.
Objective:The objective of this study was to evaluate the effect of postoperative activity restriction on satisfaction and outcomes after slings.
Study design:This was a multicenter, 2-arm, noninferiority randomized controlled trial. Patients aged 18-85 years undergoing treatment with a midurethral sling were randomized 1:1 to postoperative activity restriction or liberal activity. Restrictions included avoidance of strenuous exercise and heavy lifting. The liberal group was allowed to resume activity at their discretion. Our primary outcome was satisfaction with postoperative instruction at 2 weeks. Secondary outcomes included surgical failure, mesh exposure rates, and other adverse events.
Results:In total, 158 patients were randomized with 80 to the liberal group and 78 to the restricted group. At 2 weeks, 54 (80.6%) of patients in the liberal group and 48 (73.9%) of patients in the restricted group were satisfied. We found statistical evidence supporting the hypothesis that postoperative liberal activity instruction is noninferior to activity restriction with regard to patient satisfaction (P = 0.0281). There was no significant difference in strenuous activity at 2 weeks (P = 0.0824). The liberal group reported significantly more moderate activity at 2 weeks (P = 0.0384) and more strenuous activity at 6 weeks and 6 months (P = 0.0171, P = 0.0118, respectively). The rate of recurrent or persistent stress incontinence for liberal versus restricted groups was 18.52% versus 23.53% (P = 0.635). There were no statistically significant differences in complication rates.
Conclusions:Postoperative liberal activity was noninferior to activity restriction with regard to patients' satisfaction. There was no evidence supporting a statistically significant association between postoperative instruction and negative surgical outcomes.
Trial registration:ClinicalTrials.gov NCT04552457
Document Type
Article
PubMed ID
38710013