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Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort of Absorbable and Permanent Suture Groups

Bradley, Megan, S., MD*†; Bickhaus, Jennifer, A., MD*†; Amundsen, Cindy, L., MD*†; Newcomb, Laura, K., MD; Truong, Tracy, MS; Weidner, Alison, C., MD*†; Siddiqui, Nazema, Y., MD, MHSc*†

Female Pelvic Medicine & Reconstructive Surgery: May/June 2018 - Volume 24 - Issue 3 - p 207–212
doi: 10.1097/SPV.0000000000000451
Original Articles

Objective The aim of this study was to compare anatomic results after vaginal uterosacral ligament suspension with absorbable versus permanent suture.

Methods We performed a retrospective cohort study of women who underwent vaginal uterosacral ligament suspension, from 2006 to 2015. We compared 2 groups: (1) absorbable suspension suture and (2) permanent suspension suture (even if accompanied by absorbable suture). Our primary outcome was composite anatomic failure defined as (1) recurrent prolapse in any compartment past the hymen or (2) retreatment for prolapse. Continuous variables were analyzed using the Student t test or Mann-Whitney U test, and categorical variables were analyzed using χ2 or Fisher exact test. Multivariable logistic regression analysis was performed to control for confounders. P < 0.05 was considered significant.

Results Of the 242 patients with medium-term follow-up (3 months to 2 years after surgery), 188 underwent vaginal uterosacral ligament suspension with only absorbable suture, and 54 underwent suspension with permanent suture. Compared with the absorbable suture cohort, the permanent suture cohort was more likely to have had advanced preoperative prolapse (P = 0.01), less likely to have had a prior hysterectomy (P = 0.01), and less likely to have undergone a concomitant posterior colporrhaphy/perineoplasty (P < 0.01). Overall, there were no differences in composite anatomic failure between the absorbable and permanent suture groups (17.0% vs 20.4%, P = 0.41). In multivariable logistic regression analyses, when controlling for covariates, there remained no difference in composite anatomic failure between permanent and absorbable suture groups.

Conclusions Completion of vaginal uterosacral ligament suspension using only absorbable suture affords similar anatomic outcomes in the medium term as compared with suspension with additional permanent suture.

Completion of vaginal uterosacral ligament suspensionusing only absorbable suture affords similar anatomic outcomes in the mediumterm as compared with suspension with additional permanent suture.

From the *Division of Urogynecology and Reconstructive Pelvic Surgery, †Department of Obstetrics and Gynecology, and ‡Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC.

Correspondence: Megan S. Bradley, MD, Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, Duke University Medical Center, 5324 McFarland Dr, Suite 310, Durham, NC 27707. E-mail: megan.bradley@duke.edu.

Our research was presented as a poster abstract at the American Urogynecologic Society Meeting; Denver, CO; September 27 to October 1, 2016.

N.Y.S. has protected research time that is supported by award K12-DK100024 from the National Institute of Diabetes and Digestive and Kidney Diseases. N.Y.S. has received grant funding from Medtronic Inc, but neither of these resources provided support for this study. The other authors have declared they have no conflicts of interest.

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