title: Outpatient vaginal hysterectomy: optimizing perioperative management for same-day discharge.
abstract: OBJECTIVE
  To present tactics for optimizing outpatient vaginal hysterectomy and describe perioperative outcomes in a large consecutive case series.
  
  
  METHODS
  This is a descriptive study and review of clinical outcomes in 1,071 patients selected to undergo vaginal hysterectomy for benign indications from 2000 to 2010. The setting is a single-surgeon private practice in a community hospital. Outcome measures include length of hospital stay, estimated blood loss, operative time, uterine weight, and perioperative complications, including hospital readmissions and emergency room visits.
  
  
  RESULTS
  One thousand seventy-one of 1,162 cases (92%, 95% confidence interval [CI] 90.5-93.7) were total vaginal hysterectomies, of which 1,029 (96%, 95% CI 94.9-97.3) were discharged the same day after surgery. The median operative time was 34 minutes (range 17-210 minutes), and estimated blood loss was 45 mL (range 5-800 mL). The median patient age was 46 years (range 27-86 years), and median uterine weight was 160 g (range 25-1,380 g). One hundred ninety-three patients (18%, 95% CI 15.8-20.5) were nulliparous and 218 (20%, 95% CI 18-22.9) had prior pelvic surgery. Five patients (0.5%, 95% CI 0.2-1.1) required readmission or emergency room evaluation within the first 30 days.
  
  
  CONCLUSIONS
  Vaginal hysterectomy can be successfully adopted as a same-day discharge procedure. In this population, regardless of previous pelvic surgery or nulliparity, good perioperative outcomes have been achieved.
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida 33606, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Zakaria
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Levy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D008875:Middle Aged; D061646:Operative Time; D009929:Organ Size; D010351:Patient Discharge; D010359:Patient Readmission; D019990:Perioperative Care; D016896:Treatment Outcome; D014599:Uterus / Q000033:anatomy & histology / Q000601:surgery