Morciano Andrea, Pecorella Giovanni, Tinelli Andrea, Schiavi Michele Carlo, Marzo Giuseppe, Cervigni Mauro, Scambia Giovanni
Department of Gynaecology and Obstetrics, Panico Pelvic Floor Center, Pia Fondazione "Card. G. Panico", Tricase, Lecce, Italy.
AIUG Research Group, Associazione Italiana di UroGinecologia e del Pavimento Pelvico, Rome, Italy.
Arch Gynecol Obstet. 2025 Mar;311(3):863-870. doi: 10.1007/s00404-024-07904-5. Epub 2025 Jan 20.
Despite the advent of the ERAS Program, recovery after urogynecological surgery is still a highly debated topic in clinical practice. The majority of gynecologic surgeons, in fact, continue to advise patients to home rest and to avoid lifting heavy objects after surgery. The aim of the present study was to verify the impact of a moderate-high physical activity and recovery after surgery on anatomical results after LSC, with a 2-year follow-up (FU).
Two hundred and one consecutive patients with pelvic prolapse were retrospectively selected from our database among women who underwent, from October 2019 to February 2022, a laparoscopic sacral colpopexy. Three-six and 24 months follow-up were studied. At 3 months, patients completed the IPAQ-SF Questionnaire to assess physical activity. According to IPAQ-SF, patients were divided in two arms: Low and Moderate-High activity level.
At 3 months follow-up, we obtained a high anatomic success rate in absences of statistical differences between populations, with a significative persistence of these results even at 6 and 24 months. No differences were found in terms of subjective success and vaginal mesh erosions at 3-6 months and 2-years follow-ups between patients despite differences in IPAQ-SF activity levels.
Our data highlight the need for urogynecologists, especially after LSC, to invest heavily in patient education and to shift away from the outdated concept of home rest after surgery.
尽管出现了加速康复外科（ERAS）计划，但在临床实践中，泌尿妇科手术后的恢复仍是一个备受争议的话题。事实上，大多数妇科外科医生仍建议患者术后在家休息并避免提重物。本研究的目的是通过为期2年的随访（FU），验证中高强度体力活动和术后恢复对腹腔镜骶骨阴道固定术（LSC）后解剖学结果的影响。
从我们的数据库中回顾性选取201例2019年10月至2022年2月期间接受腹腔镜骶骨阴道固定术的盆腔器官脱垂连续患者。研究了3个月、6个月和24个月的随访情况。在3个月时，患者完成国际体力活动问卷简表（IPAQ-SF）以评估体力活动。根据IPAQ-SF，患者被分为两组：低活动水平组和中高活动水平组。
在3个月的随访中，我们获得了较高的解剖学成功率，两组之间无统计学差异，且这些结果在6个月和24个月时仍显著持续存在。尽管IPAQ-SF活动水平存在差异，但在3至6个月以及2年随访时，患者在主观成功率和阴道网片侵蚀方面未发现差异。
我们的数据强调，泌尿妇科医生，尤其是在LSC术后，需要大力投入患者教育，并摒弃术后在家休息的过时观念。
