Follow-up After Urogynecologic Surgery: A Systematic Review and Meta-Analysis

Postoperative follow-up is critical in patient recovery, complication detection, and optimizing patient outcomes. Although traditionally, in-office postoperative visits have been the standard of care, remote postoperative follow-up via telehealth has emerged as a comparable alternative.

The objective was to systematically review the literature comparing in-office and remote (telehealth visits, phone calls, or apps) postoperative follow-up after urogynecologic surgery to assess the effect on patient satisfaction, health care utilization, and adverse events.

MEDLINE, CINAHL, Scopus, and ClinicalTrials.gov were searched through January 14, 2025. The population comprised women undergoing urogynecologic surgery, comparing remote follow-up methods with standard in-office visits. Outcomes assessed were patient satisfaction, health care utilization (unscheduled visits, patient-initiated calls, emergency department visits), and adverse events (eg, mesh complications, urinary retention, urinary tract infections). Abstracts and full-text articles were doubly screened and doubly extracted, with study quality graded using GRADE criteria and Cochrane risk of bias assessments. Meta-analyses were conducted for pooled proportions and mean ratios.

Of 1,082 abstracts screened, 9 studies (5 randomized controlled trials, 4 retrospective studies) involving 1,270 patients were included, with 490 patients receiving remote visits and 333 receiving in-office visits. Evidence quality ranged from moderate to high. In the meta-analysis, in-office and remote follow-up had comparable patient satisfaction (89% vs 78%, P =0.30), with no significant mean difference in patient satisfaction scores (mean difference: 0, P =0.70). No difference in health care utilization metrics or adverse events (15% vs 12%, P =0.664) was found.

Remote postoperative follow-up after urogynecologic surgery demonstrated no significant differences from in-office visits regarding patient satisfaction, health care utilization, or adverse events, supporting telehealth as an effective alternative to in-office visits.