Bernadine Gracia Duindrahajeng1,2, Garry Soloan1,2, Nayla Kinanti Putri Wisnu1,2, Achmad Furqan Agussalim1,2, Tsaniya Meidini Tahsya Hermawan1,2, Geraldus Sigap Gung Binathara1,2, Muhammad Mikail Athif Zhafir Asyura2
1Newcastle University, Newcastle Upon Tyne, United Kingdom. 2Universitas Indonesia, Jakarta, Indonesia
Introduction: Pelvic organ prolapse (POP) causes pain and discomfort in about 40% of women globally. The practice of day surgery in POP management has increased to support hospital efficiency and patient satisfaction. However, there has been no meta-analysis comparing its perioperative outcomes and safety with inpatient procedures.
Method: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with systematic searches across Pubmed, EMBASE, Scopus, Proquest, ClinicalKey, Cochrane & Google Scholar up to April 2023. Risk of bias analysis was performed using Newcastle-Ottawa Scale (NOS). Random/fixed effects meta-analysis was conducted to estimate odds ratio (OR) and 95% confidence intervals (CI), followed by sensitivity analysis with funnel plot and Egger's tests when appropriate.
Results: 10 studies were analysed comparing same-day discharge (SDD) and next-day discharge (NDD). SDD patients demonstrated lower rates of readmission (OR: 0.75, 95% CI: 0.65 - 0.87, p = 0.0002, I2 = 0%), reoperation (OR: 0.78, 95% CI: 0.61 - 1.00, p = 0.05, I2= 1%), unscheduled healthcare visits (OR: 0.84, 95% CI: 0.59 - 1.21, p= 0.35, I2= 47%), overall complication (OR: 0.58, 95% CI: 0.43 - 0.77, p= 0.0002, I2=72%), haemorrhage (OR: 0.61, 95% CI: 0.17 - 2.21, p= 0.45, I2=64%), pain complaints (OR: 0.77, 95% CI: 0.55 - 1.09, p= 0.14, I2=0%), and urological complications (OR: 0.52, 95% CI: 0.27 - 1.02, p= 0.06, I2=93%).
Conclusion: Same-day surgery is a more effective and safe method in managing POP with possible benefits in cost-efficiency and quality of life.