Is Absorbable Suture Non-Inferior to Permanent Suture in Sacrospinous Ligament Suspension? A Randomized Controlled...

Area of Science:

• Urogynecology
• Pelvic reconstructive surgery
• Surgical innovation

Background:

• Sacrospinous ligament suspension (SSLS) is a common surgical repair for pelvic organ prolapse (POP).
• High 5-year failure rates (up to 70%) are associated with SSLS.
• Permanent sutures used in SSLS carry risks like erosion and bleeding, while absorbable sutures' efficacy is uncertain.

Purpose of the Study:

• To evaluate the non-inferiority of absorbable sutures compared to permanent sutures in maintaining apical support after SSLS at 12 months.
• To compare recurrence rates, suture-related complications, and patient-reported outcomes between absorbable and permanent sutures.

Main Methods:

• A randomized controlled trial involving 49 patients undergoing SSLS.
• Patients were randomized 1:1 to receive either absorbable or permanent sutures.
• Primary outcome: Pelvic Organ Prolapse Quantification (POP-Q) point C at 12 months. Secondary outcomes: prolapse recurrence, complications, and Patient Global Impression of Improvement (PGI-I).

Main Results:

• No significant difference in median POP-Q point C between groups (median -5 for both, p=0.98).
• Similar composite prolapse recurrence rates: 43.5% for absorbable vs. 50% for permanent sutures (p=0.68).
• No suture erosion or granulation observed; high patient-reported improvement in both groups (82.6% absorbable vs. 100% permanent, p=0.12).

Conclusions:

• Absorbable sutures are non-inferior to permanent sutures for apical support in SSLS at 12 months.
• Both suture types demonstrated favorable patient-reported outcomes and low complication rates.
• Absorbable sutures represent a viable alternative to permanent sutures in SSLS procedures.