Implementation of ERAS protocol can accelerate recovery after transvaginal pelvic floor reconstruction surgery in elderly: Study

A new study revealed that implementing Enhanced Recovery After Surgery (ERAS) protocols can significantly improve post-operative recovery outcomes in older patients undergoing transvaginal pelvic floor reconstruction surgery. This finding published in the BMC Medicine journal brings new hope for advancing surgical care for elderly women undergoing complex procedures.

The research involved a randomized cohort of 100 patients and compared traditional recovery methods to the ERAS approach. The results demonstrated that the ERAS protocol reduced the post-operative length of stay (LOS) by nearly 10 hours on average when compared to conventional care (65 hours versus 74 hours, P < 0.01). This reduction is a critical step forward in improving patient recovery and minimizing hospital resource use.

Beyond a shortened hospital stay, the ERAS protocol also significantly accelerated the first oral intake after surgery. The patients in the ERAS group began consuming liquids as early as 3 hours post-surgery when compared to 5 hours for the patients in the conventional group (P = 0.01). Early oral intake is essential for promoting gastrointestinal recovery and improving comfort after surgery.

There were marked improvements in pain management as well. ERAS patients reported reduced rest and movement-related pain within the first 48 hours post-operatively, with the benefit persisting throughout the 7-day follow-up. Opioid-sparing strategies were also more successfully implemented in the ERAS group which reflected the emphasis of protocol on minimizing narcotic use.

Another critical finding was the lower incidence and severity of post-operative nausea and vomiting (PONV). At the 12-hour post-operative mark, patients in the ERAS group experienced fewer nausea episodes compared to those in the conventional group. Also, the need for prolonged laryngeal mask airway support was reduced under the ERAS protocol.

The study highlights that ERAS principles, which have been widely adopted in other surgical specialties, are equally effective in pelvic floor reconstruction for older women. Key elements of the ERAS approach include optimized pain management, early mobilization, and nutritional strategies tailored to the unique needs of the patient.

The outcomes suggest that the adoption of the ERAS protocol in this patient population not only enhances recovery rates but also reduces post-operative complications and discomfort, paving the way for its broader adoption across surgical centers. Overall, this study adds valuable evidence to the growing body of literature supporting ERAS protocols in diverse surgical fields by emphasizing that age should not be a limiting factor in optimizing patient care pathways. 

Source:

Huang, X., Deng, S., Lei, X., Lu, S., Dai, L., & She, C. (2025). Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial. BMC Medicine, 23(1). https://doi.org/10.1186/s12916-025-03880-y