4.2. Results in context of ERAS programmes
We obtained no data on urinary retention or length of stay. However, a
case-control study that evaluated vaginal packing together with other
interventions within an ERAS programme concluded that packing might
negatively affect both hospital stay and costs (18). The study group
comprised women undergoing vaginal hysterectomy who had been enrolled in
an ERAS program where the standard practice was not to pack the vagina.
After reviewing the results of packing together with other interventions
within ERAS pathways for vaginal hysterectomy, Kalogera et al. (19) and
Jeppson et al. (22) came to the same conclusions.
Though we could not obtain data on the effect of vaginal packing alone
on urinary retention and length of admission, it seems logical that any
impact of vaginal packing on bladder emptying will be negative. A tight
gauze in the vagina can be expected to exert compression on the bladder
neck and urethra, thus making it difficult to void spontaneously. Due to
this belief, many surgeons prefer to place an indwelling bladder
catheter while the vagina remains packed, with both interventions
usually performed in tandem and likely to present barriers to early
discharge.
Overall, we found that the intervention offered no clear benefit for the
predefined outcomes.