High uterosacral ligament vaginal vault suspension: comparison of absorbable vs. permanent suture for apical fixation

• Published in: International Urogynecology Journal Vol. 23; no. 7; pp. 941 - 945
• Main Authors: Kasturi, Seshadri, Bentley-Taylor, Miriam, Woodman, Patrick J., Terry, Colin L., Hale, Douglass S.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-07-2012; Springer Nature B.V
• Subjects: Female; Gynecology; Humans; Ligaments - surgery; Medicine; Medicine & Public Health; Middle Aged; Original Article; Retrospective Studies; Suture Techniques; Sutures; Treatment Outcome; Urology; Uterine Prolapse - surgery; Uterosacral suspension; Apical support; Absorbable suture; Permanent suture
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-012-1708-0

Introduction and hypothesis
The primary objective of this study was to compare outcomes of absorbable and permanent suture for apical support with high uterosacral ligament vaginal vault suspension (HUSLS). The secondary objective was to investigate the rate of suture erosion.
Methods
This was a retrospective study of patients who underwent HUSLS with delayed absorbable and primarily permanent suture. Apical support was calculated as a new variable: Percent of Perfect Ratio (POP-R). This variable measures apical support as the position of the apex in relation to vaginal length.
Results
At 1-year follow-up, there was no significant difference in apical support between the two groups. The number of patients who suffered from suture erosion in the cohort that received permanent suture was 11 (22%).
Conclusions
Permanent suture, in comparison with delayed absorbable suture, for HUSLS does not offer significantly better apical support at short-term follow-up. It is also associated with a high rate of suture erosion.