Same Day Discharge Following Pelvic Reconstructive Surgery

Study Overview
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Brief Summary
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This is a prospective cross-sectional study to describe patients' perceptions and experience regarding same day discharge following pelvic reconstructive surgery including total vaginal hysterectomy, in order to improve future patient counseling and expectations.

Detailed Description
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In response to COVID-19, the urogynecology department at TriHealth has recently transitioned to a same day discharge (SDD) model for our major pelvic reconstruction surgeries with total vaginal hysterectomy. Traditionally, these patients were admitted for overnight observation and discharged to home on postoperative day one. SDD after major pelvic reconstructive surgery is new in our department, but multiple studies have shown that SDD after hysterectomy is safe, cost effective, and well received by patients. While patients have been accepting of SDD, they often have questions in the preoperative period about what to expect once they are discharged home. Previous research has shown that patients appreciate advice and recommendations from others who have previously had the same surgery; often reporting improved outcomes and satisfaction. Direct advice and narrative stories from other patients can provide a more personal experience of the day-to-day coping postoperatively that the physician cannot necessarily provide. We would like to get our patients' perspective on what happened immediately after surgery, in the hospital and at home. By expanding our awareness as providers of what challenges patients face upon discharge, we will be better able to counsel patients in the preoperative period, improve patient satisfaction with surgery and SDD, and help develop strategies to mitigate areas of concern regarding the surgical process.

Official Title
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Patient's Perceptions Regarding Same Day Discharge Following Pelvic Reconstructive Surgery: What do They Want Other Patients to Know?

Conditions
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Same Day Discharge, Pelvic Organ Prolapse, Total Vaginal Hysterectomy

Intervention / Treatment
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* Procedure: Pelvic Reconstructive Surgery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Total vaginal hysterectomy with or without bilateral salpingectomy/oophorectomy Apical repair with uterosacral ligament suspension or sacrospinous ligament fixation They may also have any of the following concurrent procedures: Anterior repair, Posterior repair, Enterocele repair, Suburethral sling for incontinence Surgery by one of the fellowship trained urogynecologists at TriHealth English speaking Exclusion Criteria: Enrollment in the Diazepam Research Study (Protocol ID:19-130) Concomitant procedure with another surgeon Chronic pain conditions that require daily use of narcotic pain medications (including but not limited to: chronic back or pelvic pain, interstitial cystitis, fibromyalgia) Concomitant anal sphincteroplasty, mesh removal or use of mesh for prolapse (excluding sling procedures)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Pelvic Reconstructive Surgery|Pelvic Reconstructive Surgery including total vaginal hysterectomy|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects who satisfied with the results of the surgery | Number of subjects who answered either Very Satisfied or Satisfied to a Likert scale question How satisfied are you with the results of your surgery. The liker scale choices are Very Satisfied, Satisfied, Neutral, Unsatisfied, and Very Unsatisfied. | Approximately 2 weeks postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of subjects who satisfied with the results of the surgery | Number of subjects who answered either Very Satisfied or Satisfied to a Likert scale question How satisfied are you with the results of your surgery. The liker scale choices are Very Satisfied, Satisfied, Neutral, Unsatisfied, and Very Unsatisfied. | Approximately 12 weeks postoperatively |