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ToolsCurtis, Thomas James, Mukhopadhyay, Sambit, Giarenis, Ilias and Gray, Thomas Giles (2024) A national survey of UK practice for day-case vaginal prolapse surgery:Unrealistic expectations? European Journal of Obstetrics and Gynecology and Reproductive Biology, 293. pp. 72-77. ISSN 0301-2115
Full text not available from this repository. (Request a copy)Abstract
Objective: The UK NHS Getting It Right First Time report (2021) recommended that a significant proportion of native tissue vaginal prolapse operations should be undertaken as day-case procedures (target: 80% anterior compartment, 70% posterior compartment, 60% combined anterior/posterior compartment). The evidence for perioperative care, options for anaesthesia and outcomes of day-case vaginal prolapse surgery is limited. This study aimed to establish current practice amongst UK gynaecologists and explore perceived barriers to implementing day-case surgery for pelvic organ prolapse. Study design: A pre-tested 16-item survey was emailed to British Society of Urogynaecology members in July 2022. This survey recorded rates of day-case prolapse surgeries, barriers to implementation and practices for managing urethral catheters, vaginal packs, intraoperative anaesthetics and perioperative care. Responses to free-text questions were independently analysed by two of the authors and underwent thematic analysis. Results: 121 eligible responses were received (28 % response-rate): 41 % never undertook day-case prolapse repair, 16 % undertook < 5 per year and 26 % undertook > 20 cases per year. There was no significant difference in training level or hospital setting between those groups. Reasons cited for not undertaking day-case prolapse surgery included concerns about vaginal packs and urinary catheters (92 %) postoperative complications (67 %), early discharge of elderly patients (60 %) and a lack of published evidence (39 %) or national guidance (35 %). For those currently undertaking day-case prolapse surgery; 67 % used general anaesthesia, 15 % spinal with short-acting local anaesthetic, 14 % spinal with long-acting local anaesthetic and 3 % local anaesthetic alone. Vaginal packs and self-retaining urethral catheters were used by 68 % and 70 % respectively. Concerns regarding the management of vaginal packs and urinary catheters were the most frequently cited barrier to implementing day-case surgery for pelvic organ prolapse amongst free-text responses. There were wide variations in managing catheters and packs, and in managing readmissions. Conclusions: There is significant variation in uptake and practice for day-case prolapse surgery in the UK, with legitimate clinical concerns a barrier to its implementation. Further evaluation and development of robust, evidence-based management pathways are required to make day-case prolapse surgery consistent, feasible and defensible in clinical practice.
| Item Type: | Article |
|---|---|
| Additional Information: | Publisher Copyright: © 2023 Elsevier B.V. |
| Uncontrolled Keywords: | catheter,day-case,pack,prolapse,surgery,survey,reproductive medicine,obstetrics and gynaecology ,/dk/atira/pure/subjectarea/asjc/2700/2743 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 03 Jun 2026 16:15 |
| Last Modified: | 04 Jun 2026 09:49 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/103270 |
| DOI: | 10.1016/j.ejogrb.2023.12.025 |
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