Skip to main content

Advertisement

SpringerLink
Log in

High uterosacral ligament vaginal vault suspension: comparison of absorbable vs. permanent suture for apical fixation

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The primary objective of this study was to compare outcomes of absorbable and permanent suture for apical support with high uterosacral ligament vaginal vault suspension (HUSLS). The secondary objective was to investigate the rate of suture erosion.

Methods

This was a retrospective study of patients who underwent HUSLS with delayed absorbable and primarily permanent suture. Apical support was calculated as a new variable: Percent of Perfect Ratio (POP-R). This variable measures apical support as the position of the apex in relation to vaginal length.

Results

At 1-year follow-up, there was no significant difference in apical support between the two groups. The number of patients who suffered from suture erosion in the cohort that received permanent suture was 11 (22%).

Conclusions

Permanent suture, in comparison with delayed absorbable suture, for HUSLS does not offer significantly better apical support at short-term follow-up. It is also associated with a high rate of suture erosion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Mc CM (1957) Posterior culdeplasty; surgical correction of enterocele during vaginal hysterectomy; a preliminary report. Obstet Gynecol 10:595–602

    Article  Google Scholar 

  2. Shull BL, Bachofen C, Coates KW, Kuehl TJ (2000) A transvaginal approach to repair of apical and other associated sites of pelvic organ prolapse with uterosacral ligaments. Am J Obstet Gynecol 183:1365–1373, discussion 73-4

    Article  PubMed  CAS  Google Scholar 

  3. Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC (2000) Bilateral uterosacral ligament vaginal vault suspension with site-specific endopelvic fascia defect repair for treatment of pelvic organ prolapse. Am J Obstet Gynecol 183:1402–1410, discussion 10-1

    Article  PubMed  CAS  Google Scholar 

  4. Silva WA, Pauls RN, Segal JL, Rooney CM, Kleeman SD, Karram MM (2006) Uterosacral ligament vault suspension: five-year outcomes. Obstet Gynecol 108:255–263

    Article  PubMed  Google Scholar 

  5. Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, Walsh P (2001) High uterosacral vaginal vault suspension with fascial reconstruction for vaginal repair of enterocele and vaginal vault prolapse. Am J Obstet Gynecol 185:1339–1342, discussion 42-3

    Article  PubMed  CAS  Google Scholar 

  6. Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  7. Wong MJ, Rezvan A, Bhatia NN, Yazdany T (2011) Uterosacral ligament vaginal vault suspension using delayed absorbable monofilament suture. Int Urogynecol J Pelvic Floor Dysfunct

  8. Natale F, La Penna C, Padoa A, Agostini M, Panei M, Cervigni M (2010) High levator myorraphy versus uterosacral ligament suspension for vaginal vault fixation: a prospective, randomized study. Int Urogynecol J Pelvic Floor Dysfunct 21:515–522

    Article  Google Scholar 

  9. Yazdany T, Yip S, Bhatia NN, Nguyen JN (2010) Suture complications in a teaching institution among patients undergoing uterosacral ligament suspension with permanent braided suture. Int Urogynecol J Pelvic Floor Dysfunct 21:813–818

    Article  Google Scholar 

Download references

Conflicts of interest

Patrick J. Woodman, speaker for Pfizer, has received research grant from Ethicon Women’s Health and Urology. Douglass S. Hale, consultant for Ethicon Women’s Health and Urology.

Author information

Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Deparment of Gynecology and Obstetrics, Indiana University, 1633 North Capitol Ave, Indianapolis, IN, 46202, USA

    Seshadri Kasturi, Patrick J. Woodman & Douglass S. Hale

  2. Department of Gynecology and Obstetrics, William Beaumont Hospital, Royal Oak, MI, USA

    Miriam Bentley-Taylor

  3. Department of Biostatistics, Indiana University Health, Indianapolis, IN, USA

    Colin L. Terry

Authors
  1. Seshadri Kasturi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miriam Bentley-Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patrick J. Woodman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Colin L. Terry
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Douglass S. Hale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Seshadri Kasturi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kasturi, S., Bentley-Taylor, M., Woodman, P.J. et al. High uterosacral ligament vaginal vault suspension: comparison of absorbable vs. permanent suture for apical fixation. Int Urogynecol J 23, 941–945 (2012). https://doi.org/10.1007/s00192-012-1708-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-012-1708-0

Keywords

Search

Navigation