Skip to main content

Advertisement

SpringerLink
Log in

Comparative study of absorbable suture and permanent suture in sacrocolpopexy: a meta-analysis and systematic review

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

Abstract

Introduction and hypothesis

The aim of this study was to compare the surgical results and the complications of absorbable suture (AS) versus permanent suture (PS) in sacrocolpopexy (SCP).

Methods

We systematically searched PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library Central Register of Controlled Trials for articles in which researchers compared AS with PS in SCP. The primary outcomes were the surgical success rate and suture-related complications (suture exposure/erosion, mesh erosion, and suture removal). All analyses were performed with Review Manager 5.3.

Results

Four articles involving 689 patients were ultimately included. Our findings demonstrated that AS had similar surgical success rates to those of PS (OR=1.34; 95% CI, 0.60–2.96) and no significant differences in failure rates were noted between the two groups (OR=0.75; 95% CI, 0.34–1.66). Subgroup analyses in patients with anatomical failure revealed no significant differences in recurrent posterior prolapse (OR=0.33; 95% CI, 0.05–2.10) or in recurrent apical (OR=0.64; 95% CI, 0.03–13.66) or anterior prolapse (OR=0.45; 95% CI, 0.13–1.57). However, the AS group were at a lower risk of suture exposure/erosion (OR=0.18; 95% CI, 0.06–0.58) and a lower suture removal rate (OR=0.14; 95% CI, 0.03–0.61) and retreatment (OR=0.36; 95% CI, 0.16–0.82), but the mesh erosion was not significantly different (OR=1.00; 95% CI, 0.49–2.08).

Conclusions

The data showed that AS had a similar success rate, less exposure/erosion, and were less likely to be removed and require retreatment than PS, which supported the notion that AS is as effective as PS but safer.

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
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Wu JM, Kawasaki A, Hundley AF, Dieter AA, Myers ER, Sung VW. Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050. Am J Obstet Gynecol. 2011;205(3):230.e1–5.

    Article  PubMed  Google Scholar 

  2. Maher C, Feiner B, Baessler K, Schmid C. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2013;(4):CD004014.

  3. Padoa A, Shiber Y, Fligelman T, Tomashev R, Tsviban A, Smorgick N. Advanced cystocele is a risk factor for surgical failure after robotic-assisted laparoscopic sacrocolpopexy. J Minim Invasive Gynecol. 2022;29(3):409–15.

    Article  PubMed  Google Scholar 

  4. Arthure HG, Savage D. Uterine prolapse and prolapse of the vaginal vault treated by sacral hysteropexy. J Obstet Gynaecol Br Emp. 1957;64(3):355–60.

    Article  CAS  PubMed  Google Scholar 

  5. Geller EJ, Siddiqui NY, Wu JM, Visco AG. Short-term outcomes of robotic sacrocolpopexy compared with abdominal sacrocolpopexy. Obstet Gynecol. 2008;112(6):1201–6.

    Article  PubMed  Google Scholar 

  6. Nygaard I, Brubaker L, Zyczynski HM, Cundiff G, Richter H, Gantz M, et al. Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA. 2013;309(19):2016–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Siddiqui NY, Grimes CL, Casiano ER, Abed HT, Jeppson PC, Olivera CK, et al. Mesh sacrocolpopexy compared with native tissue vaginal repair: a systematic review and meta-analysis. Obstet Gynecol. 2015;125(1):44–55.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Marinkovic SP. Will hysterectomy at the time of sacrocolpopexy increase the rate of polypropylene mesh erosion? Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(2):199–203.

    Article  PubMed  Google Scholar 

  9. Tagliaferri V, Ruggieri S, Taccaliti C, Gentile C, Didonna T, D’Asta M, et al. Comparison of absorbable and permanent sutures for laparoscopic sacrocervicopexy: A randomized controlled trial. Acta Obstet Gynecol Scand. 2021;100(2):347–52.

    Article  PubMed  Google Scholar 

  10. Bretschneider CE, Kenton K, Geller EJ, Wu JM, Matthews CA. Pain after permanent versus delayed absorbable monofilament suture for vaginal graft attachment during minimally invasive total hysterectomy and sacrocolpopexy. Int Urogynecol J. 2020;31(10):2035–41.

    Article  PubMed  Google Scholar 

  11. Matthews CA, Geller EJ, Henley BR, Kenton K, Myers EM, Dieter AA, et al. Permanent compared with absorbable suture for vaginal mesh fixation during total hysterectomy and sacrocolpopexy: a randomized controlled trial. Obstet Gynecol. 2020;136(2):355–64.

    Article  CAS  PubMed  Google Scholar 

  12. Tan-Kim J, Menefee SA, Lippmann Q, Lukacz ES, Luber KM, Nager CW. A pilot study comparing anatomic failure after sacrocolpopexy with absorbable or permanent sutures for vaginal mesh attachment. Permanente J. 2014;18(4):40–4.

    Article  Google Scholar 

  13. Powell CR, Tachibana I, Eckrich B, Rothenberg J, Hathaway J. Securing mesh with delayed absorbable suture does not increase risk of prolapse recurrence after robotic sacral colpopexy. J Endourol. 2021;35(6):944–9.

    Article  PubMed  Google Scholar 

  14. Reisenauer C, Andress J, Schoenfisch B, Huebner M, Brucker SY, Lippkowski A, et al. Absorbable versus non-absorbable sutures for vaginal mesh attachment during sacrocolpopexy: a randomized controlled trial. Int Urogynecol J. 2022;33(2):411–9.

    Article  PubMed  Google Scholar 

  15. Borahay MA, Oge T, Walsh TM, Patel PR, Rodriguez AM, Kilic GS. Outcomes of robotic sacrocolpopexy using barbed delayed absorbable sutures. J Minim Invasive Gynecol. 2014;21(3):412–6.

    Article  PubMed  Google Scholar 

  16. Culligan PJ, Murphy M, Blackwell L, Hammons G, Graham C, Heit MH. Long-term success of abdominal sacral colpopexy using synthetic mesh. Am J Obstet Gynecol. 2002;187(6):1473–80; discussion 81–2.

    Article  PubMed  Google Scholar 

  17. Toglia MR, Fagan MJ. Suture erosion rates and long-term surgical outcomes in patients undergoing sacrospinous ligament suspension with braided polyester suture. Am J Obstet Gynecol. 2008;198(5):600.e1–4.

    Article  PubMed  Google Scholar 

  18. Maher CF, Feiner B, DeCuyper EM, Nichlos CJ, Hickey KV, O’Rourke P. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204(4):360.e1–7.

    Article  PubMed  Google Scholar 

  19. Tate SB, Blackwell L, Lorenz DJ, Steptoe MM, Culligan PJ. Randomized trial of fascia lata and polypropylene mesh for abdominal sacrocolpopexy: 5-year follow-up. Int Urogynecol J. 2011;22(2):137–43.

    Article  PubMed  Google Scholar 

  20. Rondini C, Braun H, Alvarez J, Urzúa MJ, Villegas R, Wenzel C, et al. High uterosacral vault suspension vs sacrocolpopexy for treating apical defects: a randomized controlled trial with twelve months follow-up. Int Urogynecol J. 2015;26(8):1131–8.

    Article  CAS  PubMed  Google Scholar 

  21. Noor N, Bastawros D, Florian-Rodriguez ME, Hobson D, Eto C, Lozo S, et al. Comparing minimally invasive sacrocolpopexy with vaginal uterosacral ligament suspension: a multicenter retrospective cohort study through the Fellows’ Pelvic Research Network. Urogynecology (Hagerstown). 2022;28(10):687–94.

    Google Scholar 

  22. Geller EJ, Bretschneider CE, Wu JM, Kenton K, Matthews CA. Sexual function after minimally invasive total hysterectomy and sacrocolpopexy. J Minim Invasive Gynecol. 2021;28(9):1603–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported by the National Key Research and Development Program of China (No. 2021YFC2009100), Natural Science Foundation of China (No.8177063), Huohua Project of Sichuan University (2018), and 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2017310).

Author information

Author notes

  1. Shuang Chen and Yuhao Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Shuang Chen, Liao Peng, Yuanzhuo Chen, Hong Shen & Deyi Luo

  2. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

    Shuang Chen, Liao Peng, Hong Shen & Deyi Luo

  3. Department of Urology, Fourth West China Hospital, Chengdu, Sichuan, China

    Yuhao Liu

Authors
  1. Shuang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuhao Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Liao Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuanzhuo Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hong Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Deyi Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Shuang Chen: conceptualization, methodology, data extraction, data analysis, writing original draft preparation; Yuhao Liu: data extraction, data analysis, writing original draft preparation; Liao Peng: data extraction, data analysis; Yuanzhuo Chen: discussion and data extraction; Hong Shen: discussion and data extraction; Deyi Luo: supervision.

Corresponding author

Correspondence to Deyi Luo.

Ethics declarations

Conflicts of interest

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, S., Liu, Y., Peng, L. et al. Comparative study of absorbable suture and permanent suture in sacrocolpopexy: a meta-analysis and systematic review. Int Urogynecol J 34, 993–1000 (2023). https://doi.org/10.1007/s00192-022-05427-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-022-05427-8

Keywords

Search

Navigation