To evaluate the current trends in research looking at outcomes between patients who required a postoperative voiding trial (POVT) versus those who did not require a POVT prior to discharge home after same day minimally invasive gynecologic surgery (MIGS).

Design:

A systematic literature search was performed using PubMed, MEDLINE, Scopus, web of science and Cochrane library following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for studies published 1946-2023.

Setting: N/A

Patients or Participants: Individuals undergoing same-day, minimally invasive gynecologic surgery.

Interventions: N/A

Measurements and Main Results:

The electronic search identified 1976 studies. Two studies met inclusion criteria. Samimi et al. analyzed readmission rates after discharge after an order to void vs without an order to void among 4743 patients. There was no statistically significant difference in the readmission rates between groups (0.4% vs 0.9%, OR = 2.23; 95% CI, 0.92−5.41; p =.08). Seidhoff et al. performed a subgroup analysis of outcomes between liberal (LVP) and strict (SVP) voiding protocols among 459 patients who underwent minimally invasive hysterectomies and myomectomies. 289 (63%) had LVP and 170 (37%) had SVP. 72.6% were same day discharges. There was no statistically significant difference between the number of postoperative urinary retention (POUR: 2.8% liberal vs. 5.3% strict, p = 0.17) and urinary tract infections (2.4% liberal vs. 4.7% strict, p = 0.28) between groups. LVP had a significantly shorter length of stay (9.4h vs 10.6h, p<0.01)

Conclusion:

The available literature suggests that overall rates of POUR are low and there is no difference in POUR and readmission occurrence in those who are required to undergo a POVT versus those who are not required prior to discharge home after same day MIGS. Further randomized controlled trials are needed to better define the safety of discharging patients without a voiding trial after same day MIGS.