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


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 post operative 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.
Webster
Todd M
TM
Division of Urology, University of Ottawa, Ontario, Canada.
Gerridzen
Ronald G
RG
D005205:Fascia / Q000637:transplantation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009864:Ontario; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014550:Urinary Incontinence, Stress / Q000191:economics / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data