Same-day Discharge vs Planned Admission after Surgical Treatment for Apical Prolapse

Abstract

Same day discharge (SDD) after surgery is becoming more common, with studies supporting the safety of this practice in gynecologic surgeries. The aim of this study was to compare short-term outcomes of same day discharge with planned admission in patients undergoing apical pelvic organ prolapse repair, through 30-day complications and 30- day unanticipated healthcare encounters. Female pelvic medicine and reconstructive surgery practice at a university affiliated tertiary medical center. Patients with apical prolapse who underwent surgical treatment during the study period were eligible for inclusion. Excluded were patients under the age of 18, cases planned for SDD with an unexpected admission, cases with a planned open procedure, and those performed in combination with another surgical service. none. A total of 296 patients were included in the final analysis. One-hundred and fifty-four patients had a planned admission (PA group) versus 142 who were discharged on the day of surgery (SDD group). There were no differences in reoperations, development of venous thromboembolism, and blood transfusions between the two groups. Patients in the SDD group were more likely to have no postoperative complications (95% vs 88.3%, p=0.037). Number of unanticipated urogynecology office visits, urgent/immediate care visits, readmissions, or unplanned phone calls were also similar between the two groups. There was a statistically significant difference observed in mean Emergency Department (ED) visits (0.16±0.40 in the PA group vs. 0.06±0.27 in the SDD group, p=0.02); however, this number was low in both groups. This comparative study suggests that same day discharge following apical prolapse repair is safe and may be considered for patients interested in this option.