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Long-term Physical Activity Levels and Physical Functioning Outcomes After Midurethral Sling

Shinnick, Julia K. MD*; Raker, Christina A. ScD; Sung, Vivian W. MD, MPH*

Female Pelvic Medicine & Reconstructive Surgery: April 11, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000728
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Objectives The objective of this study was to describe changes in leisure physical activity (PA) levels and physical functioning (PF) in women 60 months or more after midurethral sling for stress urinary incontinence (SUI).

Methods This is a long-term follow-up study of a previously published prospective study of women undergoing outpatient midurethral sling for SUI from 2009 to 2011. Women completed questionnaires for incontinence, PA, and PF at baseline, 6, 12, and 60 months or more postoperatively. Women were categorized as having sedentary, insufficient, or sufficient leisure PA levels by metabolic equivalents (MET min/week on the International Physical Activity Questionnaire). Physical functioning was measured from the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System. Physical activity and PF levels were compared preoperatively and at 60 months or more. Statistical tests were applied as appropriate with a P < 0.05 considered significant.

Results Of the 85 women enrolled in the primary study, contact was made with 49, and 35 completed surveys. The follow-up range was 5.8 to 8 years (median, 6.8). Baseline mean age was 49.8 (SD, 8) years. Urinary Impact Questionnaire scores were lower at 60 months or more postprocedure (33.33 vs 0, P < 0.001), with no differences at 6, 12, and 60 months or more. At baseline, 31.3% of patients had sedentary, 12.5% had moderate, and 56.3% had sufficient leisure PA levels. On long-term follow-up, this improved to 21.9% sedentary, 12.5% moderate, and 65.6% sufficient leisure PA levels. Physical functioning also improved (mean, 44.95 vs 53.18 points; P < 0.001).

Conclusions Midurethral sling procedures are associated with modest improvements in leisure PA levels and significant improvements in PF 60 months or more after surgery.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, and

Division of Research, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI.

Correspondence: Julia K. Shinnick, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, 101 Dudley St, 3rd Floor, Providence, RI 02905. E-mail: JShinnick@wihri.org.

The authors have declared they have no conflicts of interest.

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