Combined Respiratory and Kegel Exercises for Postoperative Recovery After Laparoscopic Hysterectomy: A Retrospective Controlled Study.

چکیده اصلی

This study presents a structured protocol combining respiratory and Kegel exercises for postoperative rehabilitation following laparoscopic hysterectomy and retrospectively evaluates the protocol's association with recovery outcomes. Ninety-four patients treated between January 2022 and August 2023 were retrospectively evaluated according to the postoperative rehabilitation documented in their medical records: 47 received combined respiratory and Kegel exercises in addition to routine rehabilitation (observation group), and 47 received routine rehabilitation alone (control group). The combined program was initiated on postoperative day 1 after clinical stabilization and continued during hospitalization and after discharge for 2 months; the exact postoperative hour of the first rehabilitation session was not consistently documented in the retrospective records. Because the study was retrospective, random sequence generation, allocation concealment, and prospective blinding were not performed. Baseline demographic and clinical characteristics showed no evident between-group imbalance. The observation group had earlier first flatus, earlier resumption of oral intake, and a shorter postoperative hospital stay. At the 2-month follow-up, the observation group showed fewer pelvic floor symptom indicators and better sustained- and rapid-contraction pelvic floor muscle performance. Acute postoperative pain at 12 h and 24 h was lower in the observation group. Because oral intake, first flatus, and the 12 h pain assessment occurred before or around rehabilitation initiation, these early postoperative findings were interpreted as descriptive between-group differences rather than effects attributable to the rehabilitation intervention. The observation group also had higher Incontinence Quality of Life scores and lower Pelvic Floor Impact Questionnaire-7 scores, indicating a more favorable quality-of-life profile. Receipt of combined respiratory and Kegel exercise rehabilitation was associated with more favorable postoperative recovery, although the retrospective single-center design requires cautious interpretation and prospective confirmation.

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