Permanent or absorbable suture material for sacrospinous ligament fixation: Does it matter?

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery
• Surgical innovation

Background:

• Pelvic organ prolapse (POP) significantly impacts women's quality of life.
• Sacrospinous ligament fixation (SSLF) is a surgical option for POP management.
• Suture material choice in SSLF may influence outcomes.

Purpose of the Study:

• To compare the success and safety of SSLF using permanent versus absorbable suture materials.
• To evaluate anatomical and subjective outcomes at 12 months post-surgery.

Main Methods:

• Retrospective review of 142 women undergoing SSLF between 2012 and 2021.
• Comparison of absorbable (polyglactin-910 or polydioxanone) versus permanent (polypropylene) sutures.
• Assessment of Pelvic Organ Prolapse Quantification (POP-Q) stage, quality of life, and complication rates at 12 months.

Main Results:

• No significant difference in anatomical success (POP stage < 2) between groups (69% vs 67%, p=0.77).
• Similar subjective cure rates (97.2% vs 94.3%, p=0.44) and de novo dyspareunia (5.9% vs 3.3%, p=0.49).
• Higher estimated blood loss with absorbable sutures (p=0.016) and increased immediate postoperative pain with permanent sutures (p=0.001).

Conclusions:

• Suture material choice (absorbable vs. permanent) does not significantly affect SSLF outcomes at 12 months.
• Permanent sutures are associated with increased immediate postoperative pain.
• SSLF demonstrates comparable safety and efficacy regardless of suture material used.