ABSTRACT

OBJECTIVE:

To evaluate the effect of using different suture material on outcomes of surgery for pelvic organ prolapse.

METHODS:

This was a retrospective cohort study of all patients having undergone surgery for pelvic organ prolapse from February 1997 to June 2003. All subjects underwent a comprehensive evaluation with ensuing surgery for pelvic organ prolapse.

RESULTS:

Of the 505 cases of surgery for prolapse, information on suture material was available on 423 procedures (83.8%). Poly L-lactide/glycolide (Panacryl®) was found to have the highest incidence of granulation tissue/infection (53.3%/13.3%) followed by polybutilate-coated polyester (Ethibond®) (26.3%/10.3%), polypropylene (Prolene®) (10.9%/4.5%), and polydioxanone (PDS®) (3.8%/2.5%). These differences were significant (p < 0.05). Granulation tissue was more common with vaginal surgery than other routes (19.8% vs. 7.4%), although the difference was not significant. While the overall incidence of recurrent prolapse was 33.9% (all stages) with 3.2% having stage 3 or 4 prolapse, only 9.9% required additional surgery for prolapse and/or incontinence. There was no significant difference in recurrence of prolapse or repeat surgery rates among the different suture materials.

CONCLUSIONS:

Braided sutures such as polyester and poly-L-lactide/glycolide had a much higher incidence of suture-related complications requiring treatment than monofilament sutures, making monofilament suture preferable in vaginal surgery.