OB/GYN & Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
Int Urogynecol J. 2023 Jun;34(6):1227-1233. doi: 10.1007/s00192-022-05332-0. Epub 2022 Aug 31.
Robust data comparing the timing of voiding trials following prolapse surgery are lacking. Filling in these knowledge gaps would be helpful in counseling patients preoperatively about the concerns regarding same-day discharge. We aimed to compare the rate of a failed void trial after apical pelvic organ prolapse (POP) repair between patients who were discharged on the day of surgery versus those discharged on postoperative day 1.
This was a retrospective matched case-control study of women who underwent either a laparoscopic/robotic or transvaginal apical POP surgery with or without concurrent hysterectomy. Patients who were discharged on postoperative day 0 (POD0) were identified as cases and matched to control patients discharged on postoperative day 1 (POD1). Patients were matched 1:1 based on age and surgical approach.
A total of 59 patients in each group met the inclusion criteria. Of the entire cohort, 34 (28.8%) patients failed their void trial, with no statistically significant difference between those who were discharged on POD0 versus POD1 (33.9% vs 23.7%, p=0.47). Patients who were discharged on POD0 were more likely to be diagnosed with a urinary tract infection (22.0% vs 8.4%, p=0.041) during the postoperative period.
In patients undergoing surgery for apical prolapse, there was no difference in the rate of void trial failure in those who had a catheter removal on the day of surgery compared with those who experienced removal the following day.
缺乏关于脱垂手术后排尿试验时间的有力数据。填补这些知识空白将有助于在术前向患者咨询关于当天出院的担忧。我们旨在比较接受经阴道或腹腔镜/机器人阴道前位(POP)修复术的患者在手术当天出院与术后第一天出院的患者在排空试验失败率。
这是一项回顾性病例对照研究,纳入了接受经阴道或腹腔镜/机器人阴道前位 POP 手术治疗的患者,其中包括或不包括同期子宫切除术。术后第 0 天(POD0)出院的患者被确定为病例,并与术后第 1 天(POD1)出院的对照患者相匹配。根据年龄和手术方式,对患者进行 1:1 匹配。
共有 59 例患者符合纳入标准。在整个队列中,有 34 例(28.8%)患者排空试验失败,POD0 与 POD1 出院的患者之间无统计学差异(33.9%与 23.7%,p=0.47)。POD0 出院的患者术后更有可能被诊断为尿路感染(22.0%与 8.4%,p=0.041)。
在接受阴道前位脱垂手术的患者中,在手术当天拔除导尿管与次日拔除导尿管的患者之间,排空试验失败的发生率无差异。