Eur J Obstet Gynecol Reprod Biol. 2019 Mar 5;236:36-40. doi: 10.1016/j.ejogrb.2019.01.019. [Epub ahead of print]
Prospective feasability study of ambulatory surgery for pelvic organ prolapse.
Courtieu C1, Cornille A2, Vaast M2, Lacombe S3, Panel L2.
1. Gynecologic Surgery Department, CMC Beau Soleil, Montpellier, France. Electronic address: email@example.com.
2. Gynecologic Surgery Department, CMC Beau Soleil, Montpellier, France.
3. Clinical Research Department, CMC Beau Soleil, Montpellier, France.
The aim of this study was the evaluation of ambulatory surgery (AS) rate for pelvic organ prolapse (POP).
It was a prospective observational study.
Patients were divided in two groups: Group EAS: patients eligible to ambulatory surgery and Group NEAS: patients not eligible to AS.
all patients from August 2015 to November 2016 undergoing surgery for POP in our institution.
The main outcome was overall AS rate in the population. Secondary outcomes were in NEAS group: reasons for ineligibility; in EAS group: AS success rate, reasons of failure and patient satisfaction related to AS; in each group: post operative re-admission or consultation, morbidity and global satisfaction.
There was 157patients included in the study. Eligibility criteria for AS was met for 111/157 (707%). Overall AS rate was 58% and success rate of AS was 82%. Reasons for ineligibility to AS were lack of home support (50%), home >1 h from hospital (109%), poor home conditions (2,2%), associated comorbidity (21.7%), associated procedure (4,3%) and refusal for AS (109%). Reasons for failure (20/111, 18%) of AS were unsuccessful trial of void (TOV) (65%), post operative nausea-vomiting (PONV) (15%), sub-cutaneous emphysema (5%), post-operative bleeding (5%) and faulty organization (10%). There was no unscheduled re-admission the night after surgery in EAS group. 7,2% in EAS group and 13% in the NEAS group had an unscheduled consultation. There were 4 re-admissions (3,6%) in the EAS group and 1 (2,2%) in the NEAS group during follow-up. Patient satisfaction to AS was 100% on next-day call and 923% at 6 weeks.
Ambulatory surgery rate was 58% in this population of surgically managed prolapses; AS success rate was 82%. There was no adverse events related to AS and patient satisfaction to AS at 6 weeks is high.
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