{"title":"Same Day Discharge with Vaginal Packing Following Pelvic Floor Reconstruction: An Analysis of Safety and Healthcare Utilization.","authors":"Tyler Trump, Omer Anis, Howard B Goldman","doi":"10.1007/s00192-025-06186-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Vaginal packing is sometimes placed during pelvic floor reconstructive surgery to aid with hemostasis. Historically, these patients were admitted overnight. In the interest of moving patients safely and efficiently through the discharge process select patients are discharged home with vaginal packing. The objective of this study is to assess healthcare utilization and safety among patients discharged with packing.</p><p><strong>Methods: </strong>Retrospective review of patients undergoing pelvic organ prolapse (POP) surgery by a single surgeon between 2016 and 2023. Patients were identified before and after the 2020 COVID pandemic as this marked a transition point where same day discharge became heavily emphasized. The historic cohort (group 1) represents patients admitted overnight with vaginal packing compared to those discharged home same day to remove their own packing (group 2). Healthcare utilization and complications were recorded in the first 30 days postoperatively.</p><p><strong>Results: </strong>Thirty-eight patients were identified in group 1 and 39 in group 2. Age, BMI, and estimated blood loss was similar. There were 20 total unplanned encounters with 10 in each group (p = 0.95). Unplanned encounters in group 1 were seven phone calls/messages, one office visit, and two ED visits compared to three phone calls/messages, five office visits, and two ED visits in group 2. Overall complication rate was similar with six in group 1 and seven in group 2 (p = 0.80). There were zero cases of retained packing.</p><p><strong>Conclusion: </strong>Patients may safely be discharged home with vaginal packing in place with similar rate of complications and healthcare utilization when compared to hospital admission.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Urogynecology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00192-025-06186-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction and hypothesis: Vaginal packing is sometimes placed during pelvic floor reconstructive surgery to aid with hemostasis. Historically, these patients were admitted overnight. In the interest of moving patients safely and efficiently through the discharge process select patients are discharged home with vaginal packing. The objective of this study is to assess healthcare utilization and safety among patients discharged with packing.
Methods: Retrospective review of patients undergoing pelvic organ prolapse (POP) surgery by a single surgeon between 2016 and 2023. Patients were identified before and after the 2020 COVID pandemic as this marked a transition point where same day discharge became heavily emphasized. The historic cohort (group 1) represents patients admitted overnight with vaginal packing compared to those discharged home same day to remove their own packing (group 2). Healthcare utilization and complications were recorded in the first 30 days postoperatively.
Results: Thirty-eight patients were identified in group 1 and 39 in group 2. Age, BMI, and estimated blood loss was similar. There were 20 total unplanned encounters with 10 in each group (p = 0.95). Unplanned encounters in group 1 were seven phone calls/messages, one office visit, and two ED visits compared to three phone calls/messages, five office visits, and two ED visits in group 2. Overall complication rate was similar with six in group 1 and seven in group 2 (p = 0.80). There were zero cases of retained packing.
Conclusion: Patients may safely be discharged home with vaginal packing in place with similar rate of complications and healthcare utilization when compared to hospital admission.
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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