Hofbauer Felix, Strobel Laura, Marth Christian, Widschwendter Andreas
Department of Gynaecology and Obstetrics, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Wien Klin Wochenschr. 2025 May 30. doi: 10.1007/s00508-025-02548-0.
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.
术后护理对于妇科手术后的恢复至关重要。然而，缺乏统一的指南常常让患者感到不确定，这可能会阻碍愈合。本研究旨在评估奥地利妇科医生和医院提供的行为建议，以为制定标准化的术后指导提供参考。
在2023年12月至2024年4月期间，向118名妇科医生和79家医院发送了问卷，内容涵盖宫腔镜检查、转化区大环形切除术（LLETZ）锥切术、无张力阴道吊带术（TVT）、腹腔镜检查、子宫切除术和剖宫产术后的建议。主题包括病假时长、随访、沐浴、使用卫生棉条、性行为、运动和提举限制。
收到了54名妇科医生（46%）和49家诊所（62%）的回复。诊所倾向于推荐比专科医生更严格的措施，尤其是在LLETZ、TVT和腹腔镜检查方面，而子宫切除术和剖宫产术的建议则较为一致。值得注意的是，对于LLETZ锥切术，专科医生建议休息2 - 4周，而诊所则建议休息1 - 2周（p < 0.05）。对于子宫切除术和剖宫产术，两组均建议恢复4 - 6周，并对举重、性行为和运动有所限制。建议的依据也存在差异：41%的专科医生依据个人经验，而41%的诊所引用当前证据。
本研究凸显了奥地利术后建议存在显著的异质性，并强调需要基于证据的标准化指南，以提高妇科护理的质量和一致性。
