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European Journal of Gynaecological Oncology  2021, Vol. 42 Issue (1): 110-117    DOI: 10.31083/j.ejgo.2021.01.2293
Special Issue: Topic Collection "Minimally Invasive Surgery in Gynecological Oncology"
Original Research Previous articles | Next articles
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
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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.
Key words:  Same day discharge      Laparoscopic hysterectomy      Voiding trial      Perioperative outcomes     
Submitted:  02 October 2020      Revised:  10 December 2020      Accepted:  16 December 2020      Published:  15 February 2021     
*Corresponding Author(s):  Michelle Davis     E-mail:  mdavis31@bwh.harvard.edu
About author:  These authors contributed equally.

Cite this article: 

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.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo.2021.01.2293     OR     https://ejgo.imrpress.com/EN/Y2021/V42/I1/110

[1] Tomohito Tanaka, Shoko Ueda, Shunsuke Miyamoto, Shinichi Terada, Hiromi Konishi, Yuhei Kogata, Satoe Fujiwara, Yoshimichi Tanaka, Kohei Taniguchi, Kazumasa Komura, Masahide Ohmichi. Short-term outcomes for patients with endometrial cancer who received robot-assisted modified radical hysterectomy: A retrospective observational study[J]. European Journal of Gynaecological Oncology, 2021, 42(1): 90-95.
[2] Kaori Hoshino, Yasuyuki Kinjo, Hiroshi Harada, Taeko Ueda, Yoko Aoyama, Midori Murakami, Seiji Kagami, Yusuke Matsuura, Kiyoshi Yoshino. Outcomes and complications of total laparoscopic hysterectomy after conization[J]. European Journal of Gynaecological Oncology, 2021, 42(1): 122-128.
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