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Activity restrictions after gynecologic surgery: is there evidence?
Ingrid E Nygaard1, Nadia M Hamad, Janet M Shaw
1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, UT 84132-0001, USA. Ingrid.nygaard@hsc.utah.edu
International Urogynecology Journal
|January 24, 2013
Summary
Post-surgery activity restrictions lack evidence, as intra-abdominal pressures during restricted and unrestricted activities overlap. More research is needed on physical activity
Area of Science:
- Gynecologic Surgery
- Pelvic Floor Disorders
- Physical Activity and Rehabilitation
Background:
- Surgeons often recommend rest and activity restriction after gynecologic surgery.
- Sedentary behavior (rest) may have negative effects on recovery.
- There is a need to understand the impact of physical activity on surgical outcomes.
Purpose of the Study:
- To review literature on activity restrictions imposed by gynecologic surgeons.
- To summarize intra-abdominal pressure (IAP) during specific activities.
- To overview the negative effects of sedentary behavior post-surgery.
Main Methods:
- Searched PubMed and Scopus (1970-present).
- Excluded studies on activities of daily living recovery or IAP for other conditions.
- Excluded studies not including healthy populations or maximal IAP data.
Main Results:
- No randomized trials or prospective cohort studies were found on postoperative activity and pelvic floor repair success.
- Intra-abdominal pressures during restricted and unrestricted activities overlap considerably.
- Significant variability exists in reported mean peak intra-abdominal pressures across studies.
Conclusions:
- Current activity restrictions after gynecologic surgery are not strongly evidence-based.
- Further research is urged to understand the role of physical activity in preventing recurrence of pelvic organ prolapse and urinary incontinence.
- Standardization in measuring and reporting intra-abdominal pressure is needed.
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