Behavioral recommendations following gynecological surgery

Postoperative care is critical for recovery after gynecological procedures. Yet, the absence of consistent guidelines often leaves patients uncertain, potentially hindering healing. This study aimed to assess behavioral recommendations provided by Austrian gynecologists and hospitals to inform the development of standardised postoperative guidance.

Between December 2023 and April 2024, questionnaires were sent to 118 gynecologists and 79 hospitals, covering postoperative advice for hysteroscopy, large loop excision of the transformation zone (LLETZ) conisation, tension-free vaginal tape (TVT), laparoscopy, hysterectomy, and caesarean section. Topics included duration of sick leave, follow-up, bathing, tampon use, sexual activity, sports, and lifting restrictions.

Responses were received from 54 gynecologists (46%) and 49 clinics (62%). Clinics tended to recommend more restrictive measures than specialists, particularly for LLETZ, TVT, and laparoscopy, while advice aligned for hysterectomy and caesarean section. Notably, for LLETZ conisation, specialists advised 2-4 weeks of rest, whereas clinics recommended 1-2 weeks (p < 0.05). For hysterectomy and caesarean section, both groups advised 4-6 weeks of recovery, with restrictions on weight lifting, sexual activity, and sports. Variability was also seen in the basis for recommendations: 41% of specialists relied on personal experience, while 41% of clinics cited current evidence.

This study highlights significant heterogeneity in postoperative advice across Austria and underscores the need for evidence-based, standardised guidelines to improve the quality and consistency of care in gynecology.