RCOG World Congress 2025

POST-OPERATIVE ROUTINE VAGINAL PACKS: SHOULD WE USE THEM?

Whitt, Selma; Ives, Pauline; Al-Hakeem, Jawaher; Asfour, Victoria

East Sussex Health Trust, Hastings , East Sussex, UK

INTRODUCTION

•A vaginal pack is introduced into the vaginal vault at the end of prolapse surgery

•It has traditionally been used for haemostasis and to prevent haematoma formation post-operatively

DESIGN

•Quality service improvement project- A component of GIRFT (Get it right first time)

OBJECTIVE

•To observe the impact of not using vaginal packs post-operatively for prolapse surgery on length of stay and bleeding complications after surgery.

METHOD

•Observational study of prospectively collected data

•No vaginal packs were used

•Data on return to theatre, blood transfusion and Hb drop were collected

•The catheter was removed after the patient was able to mobilise on the ward

•The length of stay was observed

RESULTS

Length of stay post-operatively

Patients with longer stay were elderly, lived alone and with significant comorbidities.

Haemoglobin levels

•Pre-operative haemoglobin level ranged from 102-159 (mean 134; median 135)

•Post-operatively the haemoglobin level ranged from 87-150 (mean 121; median 122)

CONLUSION

There was no adverse outcome from not using vaginal packs post-operatively for prolapse surgery.

Patients recovered well and safely.

Post-operative routine vaginal packs: Should we use them?