TY - JOUR
T1 - Effect of Voiding Policy on Post Anesthesia Care Unit Length of Stay for Minimally Invasive Hysterectomy
AU - Shah, Akash
AU - Molina, Andrea
AU - Moeckel, Camille
AU - Stegman, Molly
AU - Riley, Kristin
AU - Dave, Arpit
AU - Stetter, Christina
AU - Kunselman, Allen
AU - Li, Linda
N1 - Publisher Copyright:
© 2024
PY - 2025
Y1 - 2025
N2 - Study Objective: This study aims to evaluate a liberal postoperative voiding policy after minimally invasive hysterectomies to assess the impact of length of stay in the postoperative care unit (PACU). Design: This is a retrospective interrupted time series study. Patients were identified 3 months before and after the policy change, and a chart review was conducted of medical records. The study was powered to detect a difference of 60 minutes between the pre- and post-policy groups. Secondary outcomes included post operative urinary retention (POUR), postoperative readmission and urinary tract infections (UTI). Wilcoxon rank-sum tests and Fisher's exact tests were utilized to compare outcomes between the pre- and post-policy groups. Setting: All surgeries were completed within the division of Minimally Invasive Gynecologic Surgery at a single academic institution. Participants: Female patients aged 18 and older were included if they had undergone a minimally-invasive hysterectomy for benign indications between August 17, 2022 and February 17, 2023. Exclusion criteria included surgery for gynecologic cancer, concurrent incontinence or pelvic floor surgeries, or if patients had a history of urinary retention or bladder surgery. Intervention: A new liberal voiding protocol that did not require patients to void prior to discharge. Measurements and Main Results: 65 patients were identified for the pre-policy group, and 54 in the post-policy group. There was insufficient evidence to detect a difference in PACU length of stay (median 302 minutes pre vs 250 minutes post) or incidence of POUR or UTIs. Conclusion: The study concluded that a liberal voiding protocol is a feasible policy change. Although there was no statistically significant difference in the PACU length of stay, there was a trend toward decreased length of stay as the median was lower for this group. The results point toward a liberal voiding policy being safe, without changes seen in rates of POUR or UTIs.
AB - Study Objective: This study aims to evaluate a liberal postoperative voiding policy after minimally invasive hysterectomies to assess the impact of length of stay in the postoperative care unit (PACU). Design: This is a retrospective interrupted time series study. Patients were identified 3 months before and after the policy change, and a chart review was conducted of medical records. The study was powered to detect a difference of 60 minutes between the pre- and post-policy groups. Secondary outcomes included post operative urinary retention (POUR), postoperative readmission and urinary tract infections (UTI). Wilcoxon rank-sum tests and Fisher's exact tests were utilized to compare outcomes between the pre- and post-policy groups. Setting: All surgeries were completed within the division of Minimally Invasive Gynecologic Surgery at a single academic institution. Participants: Female patients aged 18 and older were included if they had undergone a minimally-invasive hysterectomy for benign indications between August 17, 2022 and February 17, 2023. Exclusion criteria included surgery for gynecologic cancer, concurrent incontinence or pelvic floor surgeries, or if patients had a history of urinary retention or bladder surgery. Intervention: A new liberal voiding protocol that did not require patients to void prior to discharge. Measurements and Main Results: 65 patients were identified for the pre-policy group, and 54 in the post-policy group. There was insufficient evidence to detect a difference in PACU length of stay (median 302 minutes pre vs 250 minutes post) or incidence of POUR or UTIs. Conclusion: The study concluded that a liberal voiding protocol is a feasible policy change. Although there was no statistically significant difference in the PACU length of stay, there was a trend toward decreased length of stay as the median was lower for this group. The results point toward a liberal voiding policy being safe, without changes seen in rates of POUR or UTIs.
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U2 - 10.1016/j.jmig.2024.12.001
DO - 10.1016/j.jmig.2024.12.001
M3 - Article
C2 - 39662725
AN - SCOPUS:85214466109
SN - 1553-4650
JO - Journal of Minimally Invasive Gynecology
JF - Journal of Minimally Invasive Gynecology
ER -