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Original Research

Open Access Special Issue

The impact of post-operative voiding trial on length of stay following laparoscopic hysterectomy: a prospective, randomized control trial

  • Michelle Davis1,†,*,
  • Kathryn Barletta2,†
  • Alexcis Ford3
  • Roni Nitecki4
  • Kevin M. Elias1
  • Ross Berkowitz1
  • Colleen Feltmate1

1Division of Gynecologic Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, 02115 MA, USA

2Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, 02115 MA, USA

3Division of Urogynecology, Advanced Gynecology, Roswell, 30076 GA, USA

4Division of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, 30076 Tx, USA

DOI: 10.31083/j.ejgo.2021.01.2293 Vol.42,Issue 1,February 2021 pp.110-117

Submitted: 02 October 2020 Accepted: 16 December 2020

Published: 15 February 2021

(This article belongs to the Special Issue Minimally Invasive Surgery in Gynecologic Oncology)

*Corresponding Author(s): Michelle Davis E-mail: mdavis31@bwh.harvard.edu

† These authors contributed equally.

Abstract

Objective: Same day discharge (SDD) is feasible following laparoscopic hysterectomy (TLH) in gynecologic oncology patients resulting in low complication and re-admission rates. Following vaginal surgery, backfill or active voiding trials have been shown to reduce hospital discharge with a catheter. The aim of this study is to determine if performing an active backfill voiding trial (AVT) vs. passive voiding trial (PVT) leads to expedited discharge following TLH. Methods: Subjects scheduled for SDD TLH were enrolled and randomized to an AVT or a PVT. The primary outcome was length of stay. Secondary outcomes include time to void, catheter replacement, admission to the extended recovery unity (ERU), post-operative pain, and complications. Results: 121 patients were randomized: 60 to an AVT and 61 to a PVT. There was a statistically significant reduction in median length of stay for patients undergoing an AVT vs. PVT (271.5 minutes vs. 329 minutes, P = 0.015). Median time to void was also decreased with an AVT vs. PVT (30 minutes vs. 289 minutes, P < 0.001). There was no difference in median pain score (2), catheter replacement, peri-operative complications, or overnight admissions between the two groups. Conclusion: There is a significant reduction in time to void and total length of stay in patients randomized to a backfill voiding trial following TLH with no increased patient discomfort. While the numbers of post-operative admissions were low and underpowered to detect a difference in admission rate, these data will help to streamline post-operative care for SDD gynecologic oncology patients.


Keywords

Same day discharge; Laparoscopic hysterectomy; Voiding trial; Perioperative outcomes


Cite and Share

Michelle Davis,Kathryn Barletta,Alexcis Ford,Roni Nitecki,Kevin M. Elias,Ross Berkowitz,Colleen Feltmate. The impact of post-operative voiding trial on length of stay following laparoscopic hysterectomy: a prospective, randomized control trial. European Journal of Gynaecological Oncology. 2021. 42(1);110-117.

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