Voiding Trial Outcomes After Prolapse Surgery: Before Versus During the COVID-19 Pandemic

Abstract

Importance Coronavirus disease 2019 (COVID-19) has changed practice patterns resulting in same-day discharge after most urogynecologic surgical procedures. Objective We aimed to determine if COVID-19 practice patterns changed patients' voiding trial (VT) results after surgery. Study Design This is a retrospective cohort study of women undergoing urogynecologic surgery at an academic tertiary care center. We compared patients who had surgery between January 1, 2019, and February 28, 2020, (pre-COVID, discharged on postoperative day [POD] 1) with those who underwent surgery between January 1, 2021, and February 28, 2022, (during COVID, discharged on POD 0 or POD 1). Demographics, surgical characteristics, and VT results were compared using nonparametric tests. A logistic regression was performed to adjust for confounders. P value <0.05 was considered statistically significant. Results A total of 237 patients were included. Patients were mostly White, older than 65 years (interquartile range, 56–73 years), and had a median parity of 2 (interquartile range, 2–3). Approximately 31% of patients in the pre-COVID group failed their VT, whereas 38% in the during-COVID group failed (P = 0.275). Moreover, 40.5% of women discharged the day of surgery failed their VT (P = 0.172). Compared with the pre-COVID group, more patients in the during-COVID group and those discharged on POD 0 contacted their surgeons with questions postoperatively (20.5% vs 35.0% and 35.4%, P = 0.014 and 0.022, respectively). Rates of urinary tract infection were similar by period and discharge day (P > 0.05). There was no statistical association between day of discharge or the COVID-19 pandemic and VT results. Conclusions Neither day of discharge nor the presence of the COVID-19 pandemic had a significant effect on postoperative outcomes, including urinary retention, after urogynecologic surgery. Same-day discharge is appropriate for most patients.