Highlights
- •Type of suture material does not affect outcome of sacrospinous ligament fixation.
- •Permanent sutures may be related to increased immediate postoperative pain.
- •Persistent gluteal pain after sacrospinous ligament fixation is a rare occurrence.
Abstract
Objective
To evaluate success and safety of sacrospinous ligament fixation (SSLF) using permanent
versus absorbable suture materials 12 months following surgery.
Study Design
Following IRB approval, the electronic medical records of women who underwent SSLF
in the gynecology department of a university-affiliated medical center from November
2012 to September 2021 were retrospectively reviewed. SSLF was carried out using Capio® and Digitex™, with either absorbable (polyglactin-910 or polydioxanone) sutures (group
1), or permanent (polypropylene) sutures (group 2), Pre-operative and post-operative
assessment included prolapse staging using the pelvic organ prolapse quantification
system and validated quality of life questionnaires (Pelvic Floor Distress Inventory
and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12). Patients
with postoperative information on objective and subjective outcome at 12 months were
included in final analysis. Anatomical success was defined as POP stage < 2 at 12-months
following surgery. For statistical analysis, the Mann-Whitney test was used for continuous
variables, Fisher’s exact test for dichotomous variables, and Chi-squared test of
independence for variables with>2 categories.
Results
During the study period, 234 women underwent SSLF. One-hundred and forty-two patients
(60.7 %) returned at the 12-month follow-up and were included in final analysis. Seventy-two
(50.7 %) patients had absorbable suture and 70 patients (49.3 %) had permanent suture.
Estimated blood loss was significantly higher in group 1 [100 (50–150) cc vs 50 (50–100)
cc respectively, p =.016]. Moderate to severe pain on POD-1 was significantly higher
in group 2 [VAS: 2.00 (0.00–4.00) vs 4.00 (3.00–5.75) respectively, p =.001]. Anatomical
success, defined as POP ≤ stage 2 at 12 months, was similar between groups: 69 % in
group 1 vs 67 % in group 2 (p =.77). Subjective cure was similar between groups, 97.2 %
in group 1 vs 94.3 % in group 2 (p =.44). At the 12-month follow-up, none of the patients
had gluteal pain. The rate of de-novo dyspareunia was similar between groups: 4 women
(5.9 %) in the absorbable suture group versus 2 women (3.3 %) in the permanent suture
group (p =.49).
Conclusions
Our findings suggest that absorbable or permanent suture material does not affect
outcome of SSLF. Permanent sutures may be related to increased immediate postoperative
pain.
Keywords
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Article info
Publication history
Published online: February 16, 2023
Accepted:
February 14,
2023
Received in revised form:
February 11,
2023
Received:
October 31,
2022
Identification
Copyright
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