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Permanent Compared With Absorbable Suture in Apical Prolapse Surgery: A Systematic Review and Meta-analysis
Bracha L Pollack1, Patrick Popiel, Miriam C Toaff
1New York Medical College, and the Departments of Obstetrics and Gynecology, Urology, and Pharmacology, and the Department of Public Health, School of Health Sciences and Practice, New York Medical College, Hawthorne, New York.
Permanent and absorbable sutures show similar high success rates for apical prolapse repair, including uterosacral ligament suspension, sacrospinous ligament suspension, and sacrocolpopexy. This meta-analysis confirms no significant difference in anatomic success between suture types.
Area of Science:
- Urogynecology and Pelvic Reconstructive Surgery
- Surgical Innovation and Materials Science
Background:
- Pelvic organ prolapse (POP) affects a significant number of women, necessitating surgical intervention.
- Native tissue vaginal suspension and sacrocolpopexy are common surgical approaches for apical POP.
- Suture material choice is a critical factor influencing surgical outcomes and patient satisfaction.
Approach:
- A systematic review and meta-analysis were conducted, searching MEDLINE, EMBASE, and ClinicalTrials.gov.
- Included studies focused on women undergoing apical POP surgery using either permanent or absorbable sutures.
- Anatomic success and adverse events were primary outcomes, assessed via meta-analysis of pooled proportions and risk ratios.
Key Points:
- No significant difference in anatomic success rates was observed between permanent and absorbable sutures for uterosacral ligament suspension and sacrospinous ligament suspension at 2-year follow-up.
- Similarly, sacrocolpopexy demonstrated comparable success rates (92% vs. 96%) for permanent versus absorbable sutures at 18-month follow-up.
- Meta-analysis revealed no statistically significant difference in the relative risk of success between permanent and absorbable sutures for both vaginal suspension and sacrocolpopexy.
Conclusions:
- Both permanent and absorbable sutures achieve similarly high medium-term anatomic success rates in apical POP surgery.
- The choice between permanent and absorbable suture does not appear to significantly impact the likelihood of anatomic success in these procedures.
- Further research may explore long-term outcomes and patient-reported measures across different suture materials.
