Are postoperative activity restrictions evidence-based?

Background Many surgeons restrict activities postoperatively. Intra-abdominal pressure during some activities is known; however, many everyday activities have not been studied. Our aim was to compare the intra-abdominal pressures created during unavoidable physical activities with activities that commonly are restricted after surgery. Methods Nine healthy subjects (2 men, 7 women; age, 28 ± 7 y) performed 5 repetitions of various activities while their intravesicular pressures was measured. Results The resting intravesicular pressure was 17 ± 5 mm Hg, increasing to a maximum of 112 ± 35 mm Hg during forceful coughing. The intravesicular pressure increase was greatest with forceful coughing, followed by the Valsalva maneuver. Conclusions The results suggest that the greatest increase in intra-abdominal pressure occurs during some unavoidable activities. Based on this study, postoperative restrictions may be unnecessary. Further experience based on a larger study is needed to answer this important clinical question.