Return to Baseline Activity Following Vaginal Pelvic Organ Prolapse Repair

Importance A lack of data on the time course of recovery following pelvic organ prolapse surgery limits evidence-based counseling. Objectives The objective of this study was to define the time course of recovery following vaginal native tissue prolapse repair and identify factors affecting recovery. We hypothesized that half of the patients would return to baseline activity by 6 weeks. Study Design This was a secondary analysis of a previously published randomized controlled trial of perioperative pain control for women ≥18 years undergoing vaginal native tissue prolapse repair under general anesthesia and an enhanced recovery after surgery protocol. The Activities Assessment Scale was used to quantify perioperative functional status. Our primary outcome was the proportion of participants returning to baseline activity at 1,2, 6, and 12 weeks postoperatively. Secondary outcomes included factors associated with recovery. Results Sixty-five participants (aged: 69.1±10.2 years) undergoing vaginal apical prolapse procedures were included. More than half (52.3%) returned to their baseline activity by 1 week postoperatively, with 69.2%, 84.1%, and 93.6% returning to baseline activity by 2, 6, and 12 weeks, respectively. On final multivariable analysis, chronic obstructive pulmonary disease [OR: 0.02 (95% CI, 0.001–0.43), P <0.05], total intraoperative morphine equivalents [OR: 0.89 (95% CI, 0.80–0.98), P <0.05], and total postanesthesia care unit phase 2 morphine equivalents [OR: 0.72 (95% CI, 0.52–0.99), P <0.05] were negatively associated with 6-week recovery. Conclusions In women undergoing apical vaginal prolapse repair, >50% recovered baseline functional activity by 1 week, and >80% recovered by 6 weeks.