Characterization and classification of clinical outcomes among ambulatory gynecologic surgery recipients at Kyabirwa Surgical Center, Budondo Sub-County, Jinja City: A Retrospective Chart Review

Abstract Background The global burden of gynecological diseases is increasing, along with challenges in accessing necessary prophylactic and curative surgery due to high costs, especially in sub-Saharan Africa. Ambulatory gynecologic surgery offers a potential solution however; its adoption depends on evidence of a low rate of adverse outcomes. Objective To characterize and classify the clinical outcomes of ambulatory gynecological surgery at Kyabirwa Surgical Center, Budondo Sub-county, Jinja City, Uganda. Method A retrospective chart review of 112 women who underwent major ambulatory gynecologic surgery between April 2023 and October 2025 was conducted. A census was conducted and medical record abstraction was used to collect data, which were analyzed using descriptive statistics, principal component analysis, cluster analysis, and the Kruskal-Wallis test for variance analysis. Result The prevalence of adverse clinical outcomes was 2.7%. Nine principal outcomes were identified among women who underwent major ambulatory gynecological surgery, including cardiac arrest, nausea, vomiting on postoperative days 4 to 7, febrile morbidity, vaginal discharge, superficial thrombophlebitis, intestinal injury, incisional hernias, peripheral nerve injuries, and superficial surgical site infections (grade 1). In the cluster analysis, class 2 superficial SSIs were the most prevalent (16.2%), whereas the prevalence of all other outcomes was less than 1%. The Kruskal-Wallis test showed no statistically significant differences (p > 0.05) in the incidence of surgical site infections or adverse outcomes between or within groups of women based on their intrapersonal and clinical characteristics. Conclusion Only three of 112 patients undergoing major ambulatory gynecologic surgery experienced adverse outcomes, which was significantly lower than the reported global rate at non-ambulatory facilities, ranging from 3.7 to 10.8%, a testament to the safety of this mode of care. Surgical site infections, all superficial (grade 1), were the primary postoperative outcomes of ambulatory gynecology surgery. They were classified as Clavien-Dindo class 2 and managed with oral antibiotics and analgesics, making them negligibly threatening. The incidence of surgical site infections did not differ significantly by any clinical or personal patient characteristics, suggesting that over three years of surgery, patients did not have an intraoperative, clinical, or personal trait that increased the risk of developing infections.