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Do women who self-report more exercise have increased rates of symptomatic stress urinary incontinence after midurethral slings?
Ferrante, K. L., Gantz, M. G., Sridhar, A., Smith, A., Rahn, D. D., Ellington, D. R., Weidner, A. C., Wohlrab, K., Mazloomdoost, D., Moalli, P., Lukacz, E. S., & NICHD Pelvic Floor Disorders Network (2021). Do women who self-report more exercise have increased rates of symptomatic stress urinary incontinence after midurethral slings?Female Pelvic Medicine & Reconstructive Surgery, 27(1), e202-e207. https://doi.org/10.1097/spv.0000000000000893
OBJECTIVES: There is a paucity of data on postoperative exercise and how it relates to surgical failure, specifically after midurethral sling (MUS) surgery. We aimed to assess if women with higher self-reported activity levels as measured by strenuous exercise are more likely to experience stress urinary incontinence (SUI) symptoms after MUS than women with lower self-reported activity.
METHODS: This is a secondary analysis of Operations and Pelvic Muscle Training in the Management of Apical Support Loss: the OPTIMAL Trial, a randomized trial comparing sacrospinous ligament suspension versus uterosacral ligament suspension, both with concomitant retropubic MUS. Participants completed a validated assessment of activity preoperatively and postoperatively. Women in the upper quartile for strenuous exercise (≥90 minutes per week) were compared with the remaining participants. Symptomatic SUI was defined as retreatment or reoperation for SUI and/or any positive response to Pelvic Floor Disorders Inventory stress incontinence questions 20 to 22.
RESULTS: A total of 351 participants in the OPTIMAL study received MUS along with their prolapse repair and had postoperative exercise and Pelvic Floor Disorders Inventory data. At 2 years, 87 (29%) of 305 exercised strenuously for at least 90 minutes per week, and 63 (23%) of 277 experienced SUI. Women who were less active at 2 years were significantly more likely to experience SUI than women who were more active (26.6% vs 12.8%, P = 0.0138).
CONCLUSIONS: In this study, symptomatic SUI occurred more frequently in women with lower self-reported exercise levels 2 years after MUS surgery.
