Admission–discharge policies for hysteroscopic surgery: a randomised comparison of day case with in-patient admission

ObjectiveTo study the effectiveness and acceptability of day case hysteroscopic surgery.DesignProspective randomised controlled trial.SettingAberdeen Royal Infirmary.SubjectsOne hundred and ninety four consecutive women who underwent hysteroscopic endometrial ablation.InterventionSeventy three women were allocated to day case surgery and 37 to inpatient admission; 84 women though otherwise fit for day case surgery were scheduled for in-patient admission as they lived more than 20 miles away. All women completed a questionnaire 24 h after their operations. Readmission rates were obtained from case notes. Satisfaction rates 12 months after the operation were recorded by means of a follow-up questionnaire.ResultsPost-operative pain was absent or slight in 48 (75%) of the women in the day case group 27 (84%) of women in the in-patient group, and 55 (82%) in the non-randomised in-patient group. Post-operative analgesia was necessary in 34 (52%) women in the day case group, 24 (75%) women in the in-patient group and 36 (53%) women in the non-randomised in-patient group. Hospital costs were significantly less in the day case group. Satisfaction with stay 92% in the day case group, and 100% in the other two groups.ConclusionIn this setting, day care is a safe acceptable and less expensive alternative to in-patient care for hysteroscopic endometrial ablation.