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Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion

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Postoperative Activity Restrictions After Slings: A Randomized Controlled Trial.

Erica Lai¹, Katherine McDonald², Vini Chopra³

¹From the Division of Urogynecology, Northwell Health, Queens, NY.

Urogynecology (Philadelphia, Pa.)

|May 6, 2024

Summary

This summary is machine-generated.

Liberal activity after midurethral slings is as effective as activity restriction, improving patient satisfaction. This study found no significant differences in surgical outcomes or complications between groups, challenging traditional post-operative care guidelines.

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Area of Science:

Urology
Female Pelvic Medicine and Reconstructive Surgery

Background:

Activity restriction following midurethral sling procedures is a common practice.
Evidence supporting the efficacy of postoperative activity restriction is limited.

Purpose of the Study:

To evaluate the impact of postoperative activity restriction versus liberal activity on patient satisfaction and surgical outcomes after midurethral sling placement.

Main Methods:

A multicenter, 2-arm, noninferiority randomized controlled trial was conducted.
Patients aged 18-85 years undergoing midurethral sling surgery were randomized to either activity restriction or liberal activity groups.
Primary outcome was patient satisfaction at 2 weeks; secondary outcomes included surgical failure, mesh exposure, and adverse events.

Main Results:

Patient satisfaction at 2 weeks was 80.6% in the liberal group versus 73.9% in the restricted group, demonstrating noninferiority (P = 0.0281).
No significant differences were observed in surgical failure rates (18.52% vs 23.53%, P = 0.635) or complication rates between the groups.
The liberal activity group reported increased moderate and strenuous activity levels postoperatively.

Conclusions:

Postoperative liberal activity is noninferior to activity restriction in terms of patient satisfaction following midurethral slings.
There is no evidence to support a significant association between postoperative activity instructions and negative surgical outcomes.