Evaluation of suture material used in anterior colporrhaphy and the risk of recurrence
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ORIGINAL ARTICLE
Evaluation of suture material used in anterior colporrhaphy and the risk of recurrence Emelie Valtersson 1
&
Karen Ruben Husby 1
&
Marlene Elmelund 1
&
Niels Klarskov 1
Received: 23 April 2020 / Accepted: 24 June 2020 # The International Urogynecological Association 2020
Abstract Introduction and hypothesis The wide variety of suture material used in colporrhaphy shows a lack of consensus on the optimal choice. The evidence guiding the choice of suture material is scant. The aim of this study was to investigate the effects of rapid versus slowly absorbable suture on risk of recurrence after native tissue anterior colporrhaphy. Methods This longitudinal cohort study was performed secondary to a previously published study on pelvic organ prolapse recurrence after the Manchester-Fothergill procedure versus vaginal hysterectomy. Data were collected from four Danish databases and corresponding electronic medical records. In this study, women having had anterior colporrhaphy performed were included. Suture materials were divided in three groups: rapid absorbable multifilament suture (RAMuS), rapid absorbable monofilament suture (RAMoS) and slowly absorbable monofilament suture (SAMoS). The main outcome was recurrence of prolapse in the anterior compartment. Results A total of 462 women were included in this study. No significant difference in recurrence was found among the three suture groups. However, a non-significant tendency towards a higher risk of recurrence in the RAMoS group [HR 2.14 (0.75– 6.10) p = 0.16] compared to the RAMuS group was observed. Conclusion In this study, the use of rapid absorbable multifilament suture compared to slowly absorbable monofilament suture does not seem to lead to a higher risk of recurrence after anterior colporrhaphy. Keywords Anterior colporrhaphy . Pelvic organ prolapse . Recurrence . Suture material . Suture technique
Introduction The lifetime risk for pelvic organ prolapse (POP) surgery in Denmark is 18.7% [1]. The anterior vaginal wall is the most typical compartment for a vaginal prolapse [2, 3], and the most common surgical treatment for prolapse in the anterior compartment is colporrhaphy [4, 5]. It is well known that the recurrence rate after anterior colporrhaphy is high; up to 65% has been documented in the literature [6]. Furthermore, Conference presentation Presented at ICS 2019, Gothenburg, Sweden, 5 September 2019. Presented at the Danish Urogynecological Societies annual meeting, Fredericia, Denmark, January 2020. * Emelie Valtersson [email protected] 1
Department of Gynecology and Obstetrics, Herlev and Gentofte University Hospital, Herlev Ringvej, 75 2730 Herlev, Denmark
a Danish cohort study found a reoperation rate of 12.4% in the anterior compartment [7]. Clearly, it is important to identify surgical variables that can improve the procedure and minimize the rates of recurrences and reoperations. The wide variety of suture material used in this procedure shows a lack of consensus on the optimal choice. Anterior native tiss
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