REVIEW ARTICLE Postoperative management and restrictions for female pelvic surgery: a systematic review Miles Murphy & Cedric Olivera & Thomas Wheeler II & Elizabeth Casiano & Nazema Siddiqui & Rajiv Gala & Tondalaya Gamble & Ethan M. Balk & Vivian W. Sung Received: 10 June 2012 / Accepted: 13 July 2012 / Published online: 8 August 2012 # The International Urogynecological Association 2012 Abstract Introduction and hypothesis We sought to systematically review the literature regarding the effect of postoperative restrictions on clinical outcomes after pelvic surgery. Methods English-language articles were identified by a MEDLINE and Cochrane Central Register of Controlled Trials search from inception to July 2010. We used key words describing various gynecologic surgical procedures and postoperative activities, including mobility, lifting, work, coitus, and exercise. Randomized and nonrandomized studies comparing interventions with outcomes of interest were included. Results The literature search yielded of 3,491 articles; 115 full-text articles were reviewed, and 38 met eligibility crite- ria and are reported and analyzed here. Our analysis revealed that expedited discharge protocols and early post- operative feeding and catheter removal result in shorter hospital stay without negative health outcomes. However, there are limited data to guide many other aspects of post- operative care, particularly regarding exercise and resump- tion of sexual activity after surgery. Conclusions There is good evidence to support early post- operative feeding and catheter removal after pelvic surgery. There are limited data to guide many other aspects of post- operative care. Keywords Management . Postoperative . Restrictions . Systematic review Introduction Obstetrician gynecologists routinely discuss postoperative restrictions when counseling their surgical patients. Pelvic surgery can affect sexual, digestive, and urinary tract func- tion; the return of these systems to normal function is an M. Murphy (*) Institute for Female Pelvic Medicine and Reconstructive Surgery, 1010 Horsham Road – Suite 101, North Wales, PA 19454, USA e-mail: milesmurphy@comcast.net C. Olivera State University of New York, Downstate, New York City, NY, USA T. Wheeler II Greenville Hospital System University Medical Group, Greenville, SC, USA E. Casiano University of Texas Health Science Center, San Antonio, TX, USA N. Siddiqui Duke University Medical Center, Durham, NC, USA R. Gala Ochsner Clinic Foundation, New Orleans, LA, USA T. Gamble Cook County Hospital, Northwestern University, Feinberg School of Medicine Chicago, Chicago, IL, USA E. M. Balk Tufts Medical Center, Boston, MA, USA V. W. Sung Women and Infants Hospital of Rhode Island/Alpert Medical School of Brown University, Providence, RI, USA Int Urogynecol J (2013) 24:185–193 DOI 10.1007/s00192-012-1898-5