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Gone in 24 hours: the feasibility of performing pubovaginal sling surgery with an overnight hospital stay

Todd M. Webster, Ronald G. Gerridzen

Division of Urology, University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada
Address correspondence to Dr. Ronald Gerridzen, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue,Ottawa, Ontario K1Y 4E9 Canada

Canadian Journal of Urology 2003, 10(3), 1905-1909.

Abstract

Introduction: Numerous management strategies are available for stress urinary incontinence, a significant problem for many women. The pubovaginal sling (PVS) with rectus fascia has proven efficacy with minimal morbidity. Historically, patients were admitted for an average of 4 days at the Ottawa Hospital. Since November 2001, patients have spent one night in hospital thereby cutting their total length of stay to less than 24 hours. This study assesses the feasibility of this approach.
Materials and methods: Ethics approval was obtained. All patient charts were reviewed retrospectively. Exclusion criteria included women booked for combined procedures or patient refusal. Each case was reviewed to determine if admission to hospital following surgery was required or if subsequent visits to emergency occurred. The Financial Department of the Ottawa Hospital provided financial information to estimate cost savings. Each patient was contacted and administered a standard satisfaction questionnaire.
Results: The length of stay was less than 24 hours in all but one case. One patient required a 48-hour stay secondary to postoperative nausea. No patient returned to the ER for assessment following discharge. The estimated cost savings were $2709 per case. Patients tolerated having this procedure performed on a daycare basis.
Conclusions: PVS may be performed safely as short stay surgery with a high degree of patient satisfaction. This results in increased efficiency and improved utilization of increasingly limited healthcare resources.

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