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Published in: International Urogynecology Journal 2/2012

01-02-2012 | Original Article

Permanent suture used in uterosacral ligament suspension offers better anatomical support than delayed absorbable suture

Authors: Christopher P. Chung, Richard Miskimins, Thomas J. Kuehl, Paul M. Yandell, Bobby L. Shull

Published in: International Urogynecology Journal | Issue 2/2012

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Abstract

Introduction and hypothesis

The objective of this study was to compare the outcomes of uterosacral ligament suspension (USLS) procedures in relation to suture material used for apical suspension.

Methods

A retrospective chart review was performed for two senior surgeons who supervised and performed USLS with both suture types in 2008–2009. Permanent and delayed absorbable sutures were compared for failure of anatomical support. Failure, defined as recurrent prolapse beyond the hymen, was evaluated using survival analysis.

Results

Two hundred forty-eight procedures were performed. One percent in the permanent group had a loss of support beyond the hymen compared to 6% in the delayed absorbable group (p = 0.034). The preoperative prolapse stage and duration of follow-up did not differ between the two groups. The number of sutures used did not differ between patients who failed and those who did not fail.

Conclusions

The use of permanent sutures for USLS of the vaginal apex was associated with a lower failure rate than delayed absorbable sutures in the short-term.
Literature
1.
go back to reference Tegerstedt G, Maehle-Schmidt M, Nyrén O, Hammarström M (2005) Prevalence of symptomatic pelvic organ prolapse in a Swedish population. Int Urogynecol J Pelvic Floor Dysfunct 16:497–503PubMedCrossRef Tegerstedt G, Maehle-Schmidt M, Nyrén O, Hammarström M (2005) Prevalence of symptomatic pelvic organ prolapse in a Swedish population. Int Urogynecol J Pelvic Floor Dysfunct 16:497–503PubMedCrossRef
2.
go back to reference Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL (2007) Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol 109:1396–1403PubMedCrossRef Rortveit G, Brown JS, Thom DH, Van Den Eeden SK, Creasman JM, Subak LL (2007) Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol 109:1396–1403PubMedCrossRef
3.
go back to reference 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 183:1365–1373PubMedCrossRef 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 183:1365–1373PubMedCrossRef
4.
go back to reference Wheeler TL 2nd, Gerten KA, Richter HE, Duke AG, Varner RE (2007) Outcomes of vaginal vault prolapse repair with a high uterosacral suspension procedure utilizing bilateral single sutures. Int Urogynecol J Pelvic Floor Dysfunct 18:1207–1213PubMedCrossRef Wheeler TL 2nd, Gerten KA, Richter HE, Duke AG, Varner RE (2007) Outcomes of vaginal vault prolapse repair with a high uterosacral suspension procedure utilizing bilateral single sutures. Int Urogynecol J Pelvic Floor Dysfunct 18:1207–1213PubMedCrossRef
5.
go back to reference Lin LL, Phelps JY, Liu CY (2005) Laparoscopic vaginal vault suspension using uterosacral ligaments: a review of 133 cases. J Minim Invasive Gynecol 12:216–220PubMedCrossRef Lin LL, Phelps JY, Liu CY (2005) Laparoscopic vaginal vault suspension using uterosacral ligaments: a review of 133 cases. J Minim Invasive Gynecol 12:216–220PubMedCrossRef
6.
go back to reference Silva WA, Pauls RN, Segal JL, Rooney CM, Kleeman SD, Karram MM (2006) Uterosacral ligament vault suspension: five-year outcomes. Obstet Gynecol 108:255–263PubMedCrossRef Silva WA, Pauls RN, Segal JL, Rooney CM, Kleeman SD, Karram MM (2006) Uterosacral ligament vault suspension: five-year outcomes. Obstet Gynecol 108:255–263PubMedCrossRef
7.
go back to reference Rardin CR, Erekson EA, Sung VW, Ward RM, Myers DL (2009) Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches. J Reprod Med 54:273–280PubMed Rardin CR, Erekson EA, Sung VW, Ward RM, Myers DL (2009) Uterosacral colpopexy at the time of vaginal hysterectomy: comparison of laparoscopic and vaginal approaches. J Reprod Med 54:273–280PubMed
8.
go back to reference Margulies RU, Rogers MA, Morgan DM (2010) Outcomes of transvaginal uterosacral ligament suspension: systematic review and metaanalysis. Am J Obstet Gynecol 202:124–134PubMedCrossRef Margulies RU, Rogers MA, Morgan DM (2010) Outcomes of transvaginal uterosacral ligament suspension: systematic review and metaanalysis. Am J Obstet Gynecol 202:124–134PubMedCrossRef
9.
go back to reference Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538PubMedCrossRef Whiteside JL, Weber AM, Meyn LA, Walters MD (2004) Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 191:1533–1538PubMedCrossRef
10.
go back to reference Swift SE, Pound T, Dias JK (2001) Case-control study of etiologic factors in the development of severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 12:187–192PubMedCrossRef Swift SE, Pound T, Dias JK (2001) Case-control study of etiologic factors in the development of severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 12:187–192PubMedCrossRef
11.
go back to reference Patterson D, Sanses TV, Gamble TL, Abbasy S, Nguyen AL, Shahryarinejad A, Saks EK, Hoskey KA, Weber-Lebrun EE, Molden S, Lowenstein L, Young SB (2009) Abdominal sacrocolpopexy and uterosacral ligament suspension for pelvic organ prolapse: does a choice of suture material at the vaginal cuff affect anatomic outcomes? J Pelvic Med Surg 15:243CrossRef Patterson D, Sanses TV, Gamble TL, Abbasy S, Nguyen AL, Shahryarinejad A, Saks EK, Hoskey KA, Weber-Lebrun EE, Molden S, Lowenstein L, Young SB (2009) Abdominal sacrocolpopexy and uterosacral ligament suspension for pelvic organ prolapse: does a choice of suture material at the vaginal cuff affect anatomic outcomes? J Pelvic Med Surg 15:243CrossRef
Metadata
Title
Permanent suture used in uterosacral ligament suspension offers better anatomical support than delayed absorbable suture
Authors
Christopher P. Chung
Richard Miskimins
Thomas J. Kuehl
Paul M. Yandell
Bobby L. Shull
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 2/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1556-3

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