Physical activity after single incision sling for stress urinary incontinence: Our experience

Objectives: The post-operative management of patients undergoing urogynecologic surgery remains controversial, despite the adoption of enhanced recovery protocols. This study aimed to evaluate the influence of moderate-to-high physical activity on functional and subjective outcomes after implantation of the Altis ® single-incision sling, with an 18-month follow-up ( FU ). Methods: A total of 222 consecutive women treated for stress urinary incontinence ( SUI ) between December 2019 and March 2022 were retrospectively reviewed. At 3-month FU , participants completed the International physical activity Questionnaire-Short Form (IPAQ-SF). Based on IPAQ-SF results, patients were categorized into Low or Moderate-High activity groups. Objective and subjective outcomes were compared at 3 and 18 months. Results: Both activity groups achieved high objective and subjective success rates, with no statistically significant differences at either follow-up interval. These results were maintained at 18 months. No correlation emerged in functional or objective results between activity level and surgical outcomes. Conclusion: Moderate or high post-operative physical activity did not adversely affect functional or patient-reported outcomes after Altis ® sling implantation. These findings support the Enhanced Recovery After Surgery ( ERAS ) philosophy and highlight the importance of abandoning unnecessary post-operative rest recommendations following SUI surgery.