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

Measurement of Physical Activity Using Fitness Trackers Before and After Midurethral Sling

IMPORTANCE

Urinary incontinence can be a barrier to performing physical activities for many women. A midurethral sling (MUS) has shown symptom improvement for women experiencing stress urinary incontinence (SUI), suggesting the hypothesis that physical activity rates should increase after treatment.

OBJECTIVE

The aim of this study was to determine the change in objectively measured physical activity levels in women following placement of MUS for SUI.

STUDY DESIGN

In this prospective cohort study, patients undergoing MUS placement, with or without concomitant pelvic reconstructive surgery, were provided a commercial activity tracker. Physical activity was tracked for at least 1 week preoperatively and up to 6 months postoperatively. Participants were required to wear the tracker for at least 2 weeks in the postoperative period. The primary outcome, mean caloric daily expenditure (MCDE), was compared preoperatively and postoperatively.

RESULTS

Seventy-two patients met criteria for data inclusion. The device was worn for a mean of 18.4 ± 12.1 days preoperatively and 91.7 ± 53.3 days postoperatively. Mean participant age was 51.9 ± 9.4 years. The MCDE was significantly higher postoperatively (preoperatively: 1,673 kcal/d vs postoperatively: 2,018 kcal/d; P < 0.01). There were no significant differences in postoperative MCDE in participants who had only MUS as the primary procedure versus participants who also had a concomitant procedure (2,020 ± 216 kcal/d vs 2,015 ± 431 kcal/d; P = 0.95). Of participants with class II/III obesity, 45% had at least a 500 kcal/d increase postoperatively.

CONCLUSIONS

Treatment of SUI with MUS is associated with a significantly greater caloric expenditure in the postoperative period.

A Case-Control Study on Dietary Acid Load in Relation to Glioma

Limited data are available linking dietary factors to glioma. The current study was conducted to investigate the association between Dietary Acid Load (DAL) and odds of glioma in Iranian adults. This case-control study was done on 128 newly diagnosed patients with glioma and 256 healthy controls in Tehran, Iran. A validated detailed food frequency questionnaire (FFQ) was used to assess dietary intakes of participants. DAL was estimated using the protein to potassium ratio (Pro: K). Glioma was diagnosed based on pathological tests. A detailed questionnaire including several non-dietary confounders was also completed. Participants in the highest tertile of DAL score had a non-significant higher odds of glioma as compared to those in the lowest tertile (OR: 1.50; 95% CI: 0.88-2.57), which remained after controlling for some potential confounders (OR: 1.66; 0.70-3.91). After further adjustment for dietary intakes of meats and processed meats, legumes and nuts, fruits, salt tea, and coffee, those in the top tertile of DAL score were significantly more likely to have glioma than those in the bottom tertile (OR: 3.09; 95% CI: 1.06, 8.99; P = 0.03). This association was also reached following further adjustment for BMI (OR: 3.05; 95% CI: 1.04, 8.91; P = 0.03). We found a significant positive association between dietary acid load, as estimated by Prot:K ratio, and odds of glioma among adults. Further studies, in particular prospective cohorts with long-term follow up, are required to confirm these findings.