Same-day surgery for pelvic organ prolapse and hospital contact within 30 days

Int Urogynecol J. 2022 Jan;33(1):123-131. doi: 10.1007/s00192-021-04852-5. Epub 2021 May 27.

Abstract

Introduction and hypothesis: The practice of same-day surgery among urogynecologic surgeons is increasing worldwide, but the percentage fluctuates among nations. Our primary aim was to investigate the feasibility of same-day surgery for pelvic organ prolapse (POP) using native tissue repair and the reasons why same-day surgery was not possible. Secondarily, we aimed to investigate the cause of hospital contact within 30 days post surgery.

Methods: This is a case-control study including 803 women who underwent POP surgery performed by vaginal approach intended as same-day surgery during a 3-year period. No patients were excluded. Patients were divided into two groups: successful same-day surgery (SDSS) and same-day surgery failure (SDSF).

Results: Same-day surgery was performed successfully in 90.7% of the cases. Postoperative complications were the main cause of SDSF (76.0%), and most were caused by voiding dysfunction (VD) (42.7%). Patients receiving surgery in the apical compartment and/or surgery involving two compartments, receiving general anesthesia or having comorbidities equivalent to ASA score 3 had a greater tendency not to be able to complete same-day surgery. Regarding telephone contact with the hospital, the SDSS group was significantly less likely to call compared to the SDSF group (11.3% versus 26.7%) (p < 0.01) and the same regarding physical attendance in the department (8.9% and 24.0%) (p < 0.01). Only five patients were re-operated within 30 days because of bleeding.

Conclusions: This study demonstrates that same-day surgery for POP has high feasibility and is safe. Complications, hospitalizations and reoperations immediately after surgery and within 30 days were found to be minimal.

Keywords: Complications; Hospital contact; Prolapse; Same-day surgery; Vaginal surgery.

MeSH terms

  • Ambulatory Surgical Procedures* / adverse effects
  • Case-Control Studies
  • Female
  • Hospitals
  • Humans
  • Pelvic Organ Prolapse* / complications
  • Pelvic Organ Prolapse* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Surgical Mesh / adverse effects
  • Treatment Outcome