Early discharge following vaginal hysterectomy

Abstract

Objective: To assess the feasibility of discharging selected patients home within 72 h of vaginal hysterectomy.

Design: Women for whom vaginal hysterectomy was planned and who were invited to take part. Those who accepted were visited at home by a staff nurse experienced in gynaecology to assess home conditions and family support. If these were suitable, the general practitioner was informed and invited to comment. If the operation was uneventful women were discharged on the third post operative day and visited at home by the nurse until the seventh day.

Setting: Leeds Western Health Authority.

Main outcome measures: The number of minor complications requiring treatment by the general practitioner, the readmission rate and the acceptability to the woman and her family.

Results: For 11 out of 61, home conditions proved unsuitable for early discharge. In six of the remaining 50, abdominal hysterectomy proved preferable to vaginal. Thirty women were discharged home on the third day after vaginal hysterectomy, five on the fourth and seven on the fifth. Two developed urinary tract infections, treated by their general practitioners. Two required readmission to hospital. Twenty-eight of 30 discharged on the third post operative day and nine of 12 discharged on the fourth or fifth post operative day were enthusiastic about the scheme.

Conclusions: Early discharge following uncomplicated vaginal hysterectomy in selected patients appears to be a safe procedure, appreciated by the majority of women. Its adoption as a routine procedure would enable the surgical throughput in a unit to be maintained on a smaller bed complement.