Continuous Stitches Versus Simple Interrupted Stitches During Anterior Colporrhaphy: A Randomized Controlled Trial

Background: The anterior vaginal wall is frequently affected by prolapse, which is frequently treated with anterior colporrhaphy. However, this repair has a high recurrence rate, and no standardized approach exists. Our study aimed to compare two suture techniques concerning postoperative outcomes. Methods: This randomized, single-center trial involved patients with symptomatic pelvic organ prolapse, assigned to either continuous or interrupted stitches during anterior repair. The primary outcome was subjective symptom improvement, assessed by the German pelvic floor questionnaire 6-12 months post-surgery. Secondary outcomes included anatomical results and surgery-related adverse events per Clavien-Dindo classification (CDC). A total of 42 patients were analyzed to achieve 80% study power. Results: No significant differences were found in the pelvic floor scores between the two groups, but both groups showed significant improvements in prolapse and all other domains assessed by the questionnaire. None of the patients reported a recurrence of symptoms or required re-treatment during the follow-up visits. In patients with continuous stitches, significantly more CDC 2 and fewer CDC 1 events were noticed. The baseline prolapse stage, prolapse domain scores, age, and the stitching technique did not significantly influence the treatment success. Conclusions: We were able to demonstrate that both suture techniques are comparable and effective in improving subjective symptoms after anterior colporrhaphy, with no significant difference in outcomes between the two methods. The choice of stitching technique did not impact the recurrence of symptoms or the need for reoperation.