Follow-up After Urogynecologic Surgery: A Systematic Review and Meta-Analysis

IMPORTANCE: Postoperative follow-up is critical in patient recovery, complication detection, and optimizing patient outcomes. Although traditionally, in-office postoperative visits have been the standard of care, remote postoperative follow-up via telehealth has emerged as a comparable alternative. OBJECTIVE: The objective was to systematically review the literature comparing in-office and remote (telehealth visits, phone calls, or apps) postoperative follow-up after urogynecologic surgery to assess the effect on patient satisfaction, health care utilization, and adverse events. STUDY DESIGN: MEDLINE, CINAHL, Scopus, and ClinicalTrials.gov were searched through January 14, 2025. The population comprised women undergoing urogynecologic surgery, comparing remote follow-up methods with standard in-office visits. Outcomes assessed were patient satisfaction, health care utilization (unscheduled visits, patient-initiated calls, emergency department visits), and adverse events (eg, mesh complications, urinary retention, urinary tract infections). Abstracts and full-text articles were doubly screened and doubly extracted, with study quality graded using GRADE criteria and Cochrane risk of bias assessments. Meta-analyses were conducted for pooled proportions and mean ratios. RESULTS: Of 1,082 abstracts screened, 9 studies (5 randomized controlled trials, 4 retrospective studies) involving 1,270 patients were included, with 490 patients receiving remote visits and 333 receiving in-office visits. Evidence quality ranged from moderate to high. In the meta-analysis, in-office and remote follow-up had comparable patient satisfaction (89% vs 78%, P=0.30), with no significant mean difference in patient satisfaction scores (mean difference: 0, P=0.70). No difference in health care utilization metrics or adverse events (15% vs 12%, P=0.664) was found. CONCLUSIONS: Remote postoperative follow-up after urogynecologic surgery demonstrated no significant differences from in-office visits regarding patient satisfaction, health care utilization, or adverse events, supporting telehealth as an effective alternative to in-office visits.