ORIGINAL ARTICLE   

Minerva Ginecologica 2020 February;72(1):19-24

DOI: 10.23736/S0026-4784.20.04510-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Outpatient vaginal surgery for pelvic organ prolapse: a prospective feasibility study

Géry LAMBLIN ¹, Christophe COURTIEU ², Chloé BENSOUDA-MIGUET ¹, Laure PANEL ², Stéphanie MORET ¹, Philippe CHABERT ¹, Gautier CHENE ¹, Erdogan NOHUZ ¹ ✉

¹ Department of Gynecological Surgery and Urogynecology, Femme Mere Enfant University Hospital (HFME), Hospices Civils de Lyon, Lyon, France; ² Department of Gynecological Surgery, Beau Soleil Clinic, Montpellier, France

BACKGROUND: In the light of recent progress in pelvic organ prolapse surgery, the modalities of hospital admission need reconsidering. This work aims to assess success rate of outpatient (ambulatory) vaginal mesh surgery for genital prolapse.
METHODS: A prospective observational study was conducted between January 2015 and July 2017, including all patients presenting with POP-Q stage ≥3 anterior and/or apical prolapse.
RESULTS: Sixty-nine of the 89 eligible patients were treated on an ambulatory basis (group A); 20 required overnight admission (group B): i.e., ambulatory success rate, 77.5%. Mean operative time was 44.9±2.5 min in group A and 62±6.5 min in group B. Reasons for ineligibility for ambulatory management comprised organizational issues at home (10.5%) and excessive home-to-hospital distance (5.7%). The postoperative urinary retention rate was 4.5%. Rates for successful cystocele correction (POP-Q <2) at 2 months were similar in the two groups: 94.2% in group A and 94.4% in group B (P=ns). Mean satisfaction score was 8.6±0.3/10.
CONCLUSIONS: Outpatient anterior vaginal mesh surgery for prolapse is safe and effective. The current medical-economic context favors ambulatory management. Patient selection, prior information and continuity of care seem primordial.

KEY WORDS: Cystocele; Uterine prolapse; Pelvic organ prolapse; Ambulatory surgical procedures