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OUTPATIENT VAGINAL HYSTERECTOMY: A PILOT STUDY

From the Division of Gynecology, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, Memphis, Tennessee

To determine the feasibility and safety of outpatient vaginal hysterectomy, we conducted a prospective study of 35 patients. Inclusion criteria required that the patient: 1) had no medical problems requiring hospitalization, 2) had a work- ing telephone and a support person during the first 48 postoperative hours, 3) signed an informed consent document and understood the postoperative instructions, 4) required no concomitant surgical procedure such as anterior or posterior colporrhaphy, 5) required no additional antibiotic therapy for valvular heart disease, and 6) sustained no intraoperative injury requiring hospital monitoring. A physician contacted the patient by telephone on the evening of surgery and on postoperative days 1 and 2, and a nurse saw each patient in her home on postoperative days 1 and 2. Total hospital stay from admission to discharge from the ambulatory surgery unit was 9.4 ± 0.81 hours (range 7.8- 10.6). The mean preoperative hematocrit was 37.0 ± 3.5% (range 29.3-43.5), with a mean discharge hematocrit of 32.5 ± 4.2% (range 27-39). Follow-up hematocrit measurements at 24 hours, 48 hours, and 1 week were unchanged (P>.05) from that at hospital discharge. Two patients required hospital readmission, one on postoperative day 7 for a vaginal cuff abscess and another on postoperative day 3 for a spinal headache. On a 13-item questionnaire, most subjects rated the entire outpatient experience positively. These data suggest that outpatient vaginal hysterectomy can be a safe procedure and is well-accepted by selected patients. Based on these preliminary findings, an expanded clinical trial is warranted.

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