Abstract

OBJECTIVES
To evaluate a clinical pathway of discharge on postoperative day 3 for the tension-free vaginal mesh (TVM) procedure in patients with pelvic organ prolapse (POP).
METHODS
Between May 2006 and December 2007, 305 consecutive women with POP quantification stage 3 or 4 were planned to undergo the TVM procedure in a single general hospital. Excluding five patients with concomitant hysterectomy, a pathway (removal of the indwelling urethral catheter on the next morning, discharge on postoperative day 3) was applied to the remaining 300 patients. The perioperative complications and postoperative hospitalization were prospectively evaluated in this case series.
RESULTS
Perioperative complications were: bladder injury (11 cases, 3.7%), vaginal wall hematoma (two cases, 0.7%), rectal injury (one case, 0.3%) and temporary hydronephrosis (one case, 0.3%). None needed blood transfusion. The indwelling urethral catheters were removed on the next morning as in the pathway in 287 cases (95.6%), and none required clean intermittent catheterization at home. Postoperative hospitalization was within 3 days in 280 cases (93.3%). The six cases (2.0%) with longer hospitalization were due to complications (two cases of bladder injury, one of rectal injury, one of blood loss over 200 mL, one of temporary urinary retention, and one of hydronephrosis). Two patients were re-hospitalized within one month due to vaginal bleeding or gluteal pain.
CONCLUSIONS
Patients generally accepted the pathway of discharge on postoperative day 3 in spite of the Japanese culture preferring a longer hospital stay.

Links

Publisher Full Text

Authors

Kato K, Suzuki S, Yamamoto S, Furuhashi K, Suzuki K, Murase T, Gotoh M

Institution

Department of Female Urology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan. kumi.kato@nifty.com

Source

International journal of urology : official journal of the Japanese Urological Association 16:3 2009 Mar pg 314-7

MeSH

Adult
Aged
Aged, 80 and over
Cohort Studies
Female
Follow-Up Studies
Gynecologic Surgical Procedures
Humans
Hysteroscopy
Japan
Length of Stay
Middle Aged
Pain, Postoperative
Patient Satisfaction
Postoperative Care
Postoperative Complications
Preoperative Care
Quality of Life
Retrospective Studies
Risk Assessment
Severity of Illness Index
Suburethral Slings
Treatment Outcome
Uterine Prolapse

Pub Type(s)

Evaluation Studies
Journal Article

Language

eng

PubMed ID

19207605