Blood transfusion after vaginal hysterectomy for pelvic organ prolapse.

BACKGROUND AND AIMS: Hysterectomy is a commonly performed gynaecological procedure, and vaginal hysterectomy for the treatment of pelvic organ prolapse will become more common as our population ages. Red cell transfusion after hysterectomy has been reported in the literature as between 2.5 and 4.3%. This paper aimed to review the rate of red cell transfusion after vaginal hysterectomy for pelvic organ prolapse in three university-affiliated teaching hospitals. METHODS: We reviewed 108 vaginal hysterectomies performed across three teaching hospitals to determine the rate of post-operative blood transfusion. RESULTS: A total of 1.9% (2/108) of women received at least one unit of red cells after their vaginal hysterectomy in our cohort. The mean drop in haemoglobin was 2.0 (95% CI, 1.8-2.3, P < 0.001). CONCLUSIONS: Red cell transfusion remains lower than international figures. This may form part of patient counselling when discussing the route of hysterectomy in the future.

Patient satisfaction with a multidisciplinary colorectal and urogynaecology service.

INTRODUCTION: Traditionally, the pelvic floor has been described as three separate compartments and problems in each compartment were managed separately. A more contemporary approach is to identify the entire pelvic floor as a single dynamic compartment. Multidisciplinary pelvic floor clinics such as ours with the support of physiotherapy, clinical nurse specialists, urodynamics, and endo-anal ultrasound are uncommon. The aim of this study was to assess patient satisfaction with a joint colorectal and urogynaecology clinic. METHOD: All women who attended our service in 2015 were identified. Women who saw both a colorectal surgeon and urogynaecologist at the same clinic were included. The Satisfaction with Outpatient Services questionnaire, a multi-dimensional outpatient survey, was mailed to all women. RESULTS: A total of 364 new women attended our service in 2015. One hundred thirty-six (35.2%) saw both a colorectal surgeon and urogynaecologist at the same visit. There was a 64% (87/136) response rate to the questionnaire. Overall, all questions regarding their attendance were responded to positively by 94% (82/87) of women. Confidence and trust in the doctor examining and treating them was reported by all women. Seeing multiple specialists was of benefit to 97% (84/87) of women and 94% (82/87) would recommend the Pelvic Floor Centre. CONCLUSION: There is a high level of satisfaction amongst women attending our outpatient service. Being seen by multiple specialities at a single clinic was felt to be of benefit by the majority of women and all expressed physician confidence. Our multidisciplinary service may reduce waiting times, increase satisfaction, and is likely cost-effective.