IMACTIV: A Pilot Study of the IMpact of Unrestricted ACTIVity Following Urethral Sling Surgery.

To compare continence outcomes and health-related quality of life (HRQOL) among women with limited activity restrictions vs. traditional restrictions following mid-urethral sling (MUS) surgery.

Thirty-six women who underwent MUS surgery were randomized: 1) the Restrictions group was given traditional postoperative restrictions for six weeks while 2) the Limited Restrictions group was instructed to resume normal activities other than pelvic rest. Patients undergoing concomitant surgery for Stage 3 and 4 prolapse were excluded. Participants completed questionnaires related to urinary symptoms (UDI-6, IIQ-7) for continence outcomes and HRQOL (SF-12®) at baseline, one to six weeks, three months, six months, and at least one year after surgery.

There was no difference in mean scores on the UDI-6 or IIQ-7 between groups at baseline or any time after surgery. The Limited Restrictions group reported better scores than the Restrictions group on the SF-12® mental health component at one week (56.7 vs. 50.2, p=0.01) and four weeks (58.4 vs. 53.3, p=0.04). The Restrictions group reported better SF-12® physical health scores at five weeks (55.7 vs. 53.0, p=0.02) but there was no difference in HRQOL scores between the two groups at any other time.

In this pilot study, there was no difference in continence outcomes for women with traditional versus limited activity restrictions following MUS surgery. There were differences in HRQOL in the early post-operative period, but these differences were not sustained. Larger prospective studies are needed, but it appears that activity restrictions after MUS surgery may not be necessary.

Urology. 2021 May 16 [Epub ahead of print]

Lauren N Tholemeier, Eunice Choi, Catherine Bresee, Colby P Souders, Falisha F Kanji, Jennifer T Anger, Karyn S Eilber

Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA., Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA., Biostatistics Core at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA., Department of Urology, UT Southwestern Medical Center., Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA., Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA; Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA., Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA; Department of Surgery, Division of Urology, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: .