Patient Experiences with Standard Behavioral Restrictions after Total Laparoscopic Hysterectomy

After hysterectomy, patients are counseled on behavioral limitation, such as avoiding vaginal intercourse and heavy lifting, to try to optimize healing. There are limited data on the benefits of these restrictions and on the impact on patients. This study aimed to evaluate patients' adherence to and perception of behavioral restrictions after total laparoscopic hysterectomy.

A cross-sectional survey study of patients who underwent total laparoscopic hysterectomy and completed the survey at their postoperative appointment between January 3 and March 31, 2023. Patients had been counseled to avoid submersion in water, strenuous exercise, and lifting > 10 pounds for at least 6 weeks, and to avoid vaginal penetration for 12 weeks after surgery. Convenience sampling was used.

A total of 71 patients were eligible and 50 (70%) participated. The mean time to postoperative appointment was 32 days. Participants reported inconsistent adherence to behavioral guidelines. 49/50 (98%) patients avoided vaginal penetration, 46/50 (92%) avoided submerging in water, 21/49 (43%) avoided lifting > 10 pounds. Within 4 weeks, > 90% of patients returned to driving, housework, and shopping and 21/36 (58%) of employed patients returned to work. 21/47(45%) of participants reported that adhering to postoperative restrictions was at least "a little bit challenging," with home responsibilities cited as the primary challenge.

Patients inconsistently followed behavioral restrictions after total laparoscopic hysterectomy and described them as difficult to follow due to other responsibilities. Future studies should explore the necessity of postoperative restrictions and strategies for improving adherence to restrictions that optimize patient safety.