New Research Finds ERAS Protocol Speeds Recovery After Pelvic Surgery in Older Women

Revolutionizing Recovery: ERAS in Focus

For women aged 60–80 facing pelvic organ prolapse (POP) and undergoing transvaginal mesh (TVM) surgery, recovery can be daunting—especially in low- and middle-resource settings. Enter the Enhanced Recovery After Surgery (ERAS) program, a bundle of evidence-based interventions originally designed to make recovery safer, faster, and more comfortable.

A recent multicenter randomized controlled trial published in the Archives of Gynecology and Obstetrics explored whether a locally adapted ERAS program could transform the surgical experience for elderly women in East Asia.

What Did the Study Do?

Researchers recruited 262 women scheduled for elective TVM surgery across seven Chinese hospitals. Participants were randomly assigned to receive either the ERAS protocol or conventional perioperative care. The ERAS approach featured:

Reduced fasting and less invasive bowel prep

Opioid-sparing, multimodal pain control

Early mobilization and rapid oral intake post-surgery

Targeted urinary management and tailored nursing support

The Results: Faster, Smoother Recoveries

The findings were striking. Compared to conventional care, the ERAS group experienced:

Shorter hospital stays (median 3.92 vs. 4.99 days)

Lower pain scores within the first 24 hours

Quicker return of bowel function and assisted walking

Faster removal of urinary catheters

Crucially, these improvements did not come at the cost of higher complication rates, increased readmissions, or higher hospital bills.

Why Does This Matter?

In countries where older women may struggle with access to advanced surgical care and post-discharge support, optimizing recovery is vital. While same-day discharge—common in Western hospitals—remains rare in China, shaving even a day off recovery means less discomfort, lower risk of hospital-acquired issues, and a swifter return to daily life.

The trial also highlights the importance of adapting protocols to fit local cultures and health systems. For example, many Chinese patients value a longer inpatient recovery, and ERAS was tailored to respect these preferences while still delivering better outcomes.

Looking Ahead

The study makes a compelling case for widely implementing ERAS protocols for older women undergoing POP repair in East Asia and similar settings. As the population ages, adopting such programs could mean healthier, happier recoveries for thousands.

Key Takeaways

ERAS protocols reduced hospital stay and pain after POP surgery in women aged 60–80.

No increase in complications, readmissions, or costs was observed with ERAS.

Faster catheter removal and earlier walking were achieved in the ERAS group.

The program was customized to local healthcare culture and patient needs.

Researchers recommend routine ERAS use for older POP patients in regions where TVM surgery is common.

Citation: Yan, Y., Zhang, Y., Wang, L., et al. (2025). Effects of an enhanced recovery after surgery (ERAS) program in elder patients undergoing transvaginal reconstructive surgery for pelvic organ prolapse (POP): a multicenter randomized parallel open-label controlled trial. Archives of Gynecology and Obstetrics, 312:2221–2231. https://doi.org/10.1007/s00404-025-08212-2