Substantial variability in postoperative treatment, and convalescence recommendations following vaginal repair. A nationwide questionnaire study

Abstract

Background: Postoperative care and convalescence recommendations following vaginal surgery are generally not evidence based. The aim of this study was to describe pre and postoperative treatment, and advice and restrictions for the convalescence period, given by Danish hospital-employed gynecologists, and gynecologists in private practice, to patients undergoing vaginal repair.

Method: In 1999 all Danish gynecologists (n=433) received a tested questionnaire about postoperative treatment and convalescence recommendations following vaginal repair. Non-responders received one reminder.

Outcome measures: Pre and postoperative treatment, and expected hospital stay. Furthermore, lifting restrictions, sick leave, and convalescence before resumption of defined activities.

Results: The overall response rate was 82%. The expected postoperative hospital stay was median 3 days (range, 1-7) following anterior repair, and 2 days (range, 1-7) following posterior repair. The recommended sick leave was median 6 weeks (range, 2-12) for patients with work with heavy lifts. There were substantial differences in recommendations. Recommended lifting restrictions were median 3 kg (range, 0-20) for median 4 weeks (range, 1-12), and the recommended time till recommencement of sexual intercourse was median 4 weeks (range, 0-12). The recommended convalescence was median 4-5 weeks for strenuous activities, and median 1-2 weeks for non-strenuous activities, with ranges from 0-24 weeks. The overall, great variance could not be explained by demographic differences between gynecologists.

Conclusion: Postoperative treatment, and convalescence recommendations given by Danish gynecologists following vaginal repair, show substantial variability and are based on individual viewpoints. Evidence based guidelines and consensus are desirable.