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Patient experience with enhanced recovery and early discharge after minimally invasive sacrocolpopexy: a qualitative study

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Abstract

Introduction and hypothesis

The aim of this study was to describe patient experiences with an enhanced recovery protocol (ERP) after minimally invasive sacrocolpopexy (SCP).

Methods

We conducted 14 semi-structured telephone interviews with women who had undergone SCP and were discharged the day of the surgery (POD#0, n = 7) or spent 1 night at the hospital (POD#1, n = 7). Interviews occurred between 2 and 6 weeks after surgery. We explored the following topics: patient preparedness, preoperative education, physical recovery, emotional recovery, and overall perception of the ERP. Interviewing continued until thematic saturation was achieved. All interviews were recorded, transcribed, and analyzed to identify relevant themes.

Results

Both POD#0 and POD#1 discharge patients reported largely positive experiences regarding their preparation for surgery, at-home recovery, and access to follow-up care. Yet for some patients, the accelerated pace of the ERP felt rushed and was perceived as an absence of care rather than as an advance in treatment. Patients that elected to stay the night lived farther from ready access to care, had less robust systems of postoperative support, and worried more about the management of their pre-existing conditions.

Conclusions

Our research found that despite having consistently positive impressions of the ERP, patients shared common anxieties surrounding their surgeries including worries about access to care and the prospect of going home with a urinary catheter. Furthermore, we found that the therapeutic value of protocol recommendations such as early discharge must be made explicit to patients and often individualized to avoid being interpreted as sub-standard care.

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Authors and Affiliations

Authors

Contributions

Evans: Protocol/project development, Data analysis, Manuscript writing, Manuscript editing.

Snook: Protocol/project development, Data collection, Manuscript editing.

Yates: Protocol/project development, Data collection, Data analysis, Manuscript editing.

Bundy: Data analysis, Manuscript writing, Manuscript editing.

Abimbola: Data collection.

Myers: Protocol/project development, Manuscript editing.

Corresponding author

Correspondence to Sarah Evans.

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Financial disclaimer/conflict of interest

Funding for this study was provided by the Department of Obstetrics and Gynecology Research Fund at Atrium Health.

Erinn Myers, MD: Boston Scientific, research support; Intuitive Surgical, Cadaver Lab.

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Preoperative enhanced recovery after surgery patient education packet (DOCX 2216 kb)

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Evans, S., Snook, L., Yates, T. et al. Patient experience with enhanced recovery and early discharge after minimally invasive sacrocolpopexy: a qualitative study. Int Urogynecol J 32, 387–394 (2021). https://doi.org/10.1007/s00192-020-04431-0

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  • DOI: https://doi.org/10.1007/s00192-020-04431-0

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