# Same Day Discharge with Vaginal Packing Following Pelvic Floor Reconstruction: An Analysis of Safety and Healthcare Utilization

## TL;DR

The study shows that patients can be safely discharged the same day after pelvic floor surgery with vaginal packing, without increased complications or healthcare use.

## Contribution

It demonstrates the safety of same-day discharge with vaginal packing, challenging historical overnight admission practices.

## Key findings

- Same-day discharge with vaginal packing had similar complication rates compared to overnight admission.
- Healthcare utilization, including unplanned encounters, was comparable between the two groups.
- No cases of retained packing were observed in either group.

## Abstract

Vaginal packing is sometimes placed during pelvic floor reconstructive surgery to aid with hemostasis. Historically, these patients were admitted overnight. In the interest of moving patients safely and efficiently through the discharge process select patients are discharged home with vaginal packing. The objective of this study is to assess healthcare utilization and safety among patients discharged with packing.

Retrospective review of patients undergoing pelvic organ prolapse (POP) surgery by a single surgeon between 2016 and 2023. Patients were identified before and after the 2020 COVID pandemic as this marked a transition point where same day discharge became heavily emphasized. The historic cohort (group 1) represents patients admitted overnight with vaginal packing compared to those discharged home same day to remove their own packing (group 2). Healthcare utilization and complications were recorded in the first 30 days postoperatively.

Thirty-eight patients were identified in group 1 and 39 in group 2. Age, BMI, and estimated blood loss was similar. There were 20 total unplanned encounters with 10 in each group (p = 0.95). Unplanned encounters in group 1 were seven phone calls/messages, one office visit, and two ED visits compared to three phone calls/messages, five office visits, and two ED visits in group 2. Overall complication rate was similar with six in group 1 and seven in group 2 (p = 0.80). There were zero cases of retained packing.

Patients may safely be discharged home with vaginal packing in place with similar rate of complications and healthcare utilization when compared to hospital admission.