Patient Discharge without an Order to Void in the Outpatient Gynecologic Surgery Setting

J Minim Invasive Gynecol. 2020 Jul-Aug;27(5):1059-1062. doi: 10.1016/j.jmig.2019.09.770. Epub 2019 Sep 11.

Abstract

Study objective: To evaluate if there is a difference in hospital readmission when patients are required to void versus not required to void before discharge after a same-day gynecologic procedure.

Design: A retrospective cohort study.

Setting: An urban tertiary care hospital.

Patients: A total of 4743 patients undergoing same-day gynecologic surgery.

Interventions: The readmission rates of patients discharged home without an order to void were compared with those with an order to void. Chart review was performed for readmission within 30 days and time to discharge from the postanesthesia recovery unit.

Measurements and main results: There was no statistically significant difference in the readmission rate between patients with or without an order to void before discharge (0.4% vs 0.9%, p = .08). Only 3 patients were readmitted for urinary retention, all with an order to void before discharge. Compared with gynecologic surgeons treating benign conditions, gynecologic oncologists were 23% more likely to place an order to void before discharge. Patients without an order to void spent approximately 59 minutes more in the postanesthesia care unit compared with those required to void (p <.01).

Conclusion: Discharge without an order to void is a safe practice in patients undergoing same-day gynecologic procedures. The risk of postdischarge urinary retention is low, consistent with previously reported rates in the literature.

Keywords: Discharge; Outpatient; Postoperative; Retention; Void.

MeSH terms

  • Adult
  • Aftercare / methods
  • Aftercare / standards
  • Aftercare / statistics & numerical data
  • Aged
  • Ambulatory Surgical Procedures / adverse effects
  • Ambulatory Surgical Procedures / methods
  • Ambulatory Surgical Procedures / statistics & numerical data*
  • Cohort Studies
  • Female
  • Gynecologic Surgical Procedures / methods
  • Humans
  • Middle Aged
  • Outpatients
  • Patient Discharge* / standards
  • Patient Discharge* / statistics & numerical data
  • Patient Readmission / statistics & numerical data*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Retrospective Studies
  • Urinary Retention / diagnosis*
  • Urinary Retention / epidemiology
  • Urinary Retention / etiology
  • Urination / physiology*