Gupta, Sandhya, Rane, Ajay, Vangaveti, Venkat, Achari, Mugundan, Mubeen, Anusheh, and Gupta, Umesh (2022) Long-term experience with a modified ERAS protocol for urogynaecology day procedures. Journal of Obstetrics and Gynaecology, 42 (5). pp. 1415-1418.

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Abstract

Enhanced recovery after surgery (ERAS) protocols were first reported for colorectal and gynaecologic procedures. The main benefits have been a shorter length of stay and reduced complications. A retrospective audit was conducted of all patients who underwent ambulatory pelvic organ prolapse surgery at the Townsville Day Surgery between January 2008 and June 2019. Following the publication of a former audit, a modified ERAS protocol was adopted at our practice. We omitted a carbohydrate-rich fluid intake prior to surgery in our local protocol. Data were analysed for the type of surgery, postoperative complications, and readmissions. All surgeries were performed by a single consultant urogynecologist. A total of 1381 women underwent 1937 surgeries. Transvaginal mesh (55.8%) was the commonest procedure, followed by a posterior repair (23.9%). Ninety-five patients (4.4%) had various complications, with a failed trial of the void as the commonest complication (87 patients). Only 8 patients (0.4%) required an unplanned admission after their procedures. Site-specific ERAS protocol is effective for providing standardised care in the surgical treatment of women with pelvic organ prolapse and urinary incontinence in an outpatient setting. Complication rates are low and reduce further with experience and familiarity with the protocol.

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