Professor Seoul National University Hospital Seoul, Seoul-t'ukpyolsi, Republic of Korea
Objectives: To evaluate surgical outcomes according to nonabsorbable or delayed-absorbable suture materials used in vaginal uterosacral ligament suspension (USLS) surgery. Polypropylene (PP) and polydioxanone (PDS) were comparted.
Methods: This retrospective cohort study included 315 women who underwent vaginal USLS for pelvic organ prolapse quantification stage 2-4 prolapse and completed a 1-year follow-up. The primary outcome was composite surgical failure defined as the presence of vaginal bulging symptoms, apical descent >1/2 of total vaginal length, anterior or posterior vaginal descent beyond the hymen, or retreatment for prolapse. Secondary outcome was suture-related complications (defined as wound dehiscence, granulation tissue, or suture erosion) detected within 1 year after surgery.
Results: PP sutures were used in 207 women, and PDS sutures were used in 108 women. The rates of surgical failure was significantly higher in the PDS suture group compared to the PP suture group (36.1% vs 12.6%, p < .01). Overall suture-related complication rates were similar between the two groups. However, the rates of granulation tissue formation and suture erosion requiring intervention was significantly lower in the PDS suture group than in the PP suture group (0.9% vs 5.8%, p=.04).
Conclusions: Compared to the use of nonabsorbable PP sutures, the use of delayed-absorbable PDS sutures for vaginal USLS can reduce suture-related complications requiring intervention but increase surgical failure rates.
