Restricted Convalescence: Outcomes Following Urogynecologic Procedures

Pelvic floor disorders (PFD) dramatically affect millions of women's quality of life (QOL), and 30% of American women will undergo reconstructive surgery for urinary incontinence or pelvic organ prolapse to improve bothersome symptoms and quality of life. Surgical goals of women with PFD is often to resume their normal activities, which they have limited secondary to bothersome symptoms. Yet, traditionally surgeons placed strict postoperative restrictions on patient's activity levels for 3 months; sometimes even recommending life long lifting and activity restrictions. Activity restrictions are imposed on the premise that exercise can "weaken" surgical healing; however, emerging data from other fields suggests that increased activity may actually promote the healing process. We aim to determine whether satisfaction, recovery, and anatomic outcomes after surgery are related to type of postoperative activity recommendations (liberal versus restricted). Women having surgery for PFD will be randomized to receive either liberal or restricted postoperative activity recommendations and satisfaction, symptoms, QOL and anatomic outcomes will be measured after surgery. We hypothesize that women with liberal activity recommendations will recover more quickly and report higher satisfaction and QOL, have fewer symptoms, and have similar anatomic outcomes to women with restricted activity restrictions. These data will change paradigms of women's health and recovery after surgery.

Inclusion criteria

• Ambulatory women undergoing surgical management of pelvic organ prolapse
• Prolapse > to Stage II on POP-Q
• Age >18 yrs
• Completed childbearing
• All subjects must have given signed, informed consent prior to registration on study
• All subjects must be able to read and complete study documents

Exclusion criteria

• Wheelchair-bound women
• Women with neurologic disease (Multiple Sclerosis, Parkinson's Disease)
• Abdominal approach with laparotomy