Comparison of Two Different Suture Materials for Transvaginal Sacrospinous Fixation of the Vault: A Prospective Randomized Trial

Abstract

Abstract

Objective: The aim of this study was to compare the efficacy of polyglactin-910 (Vicryl) and polydioxanone (PDS II) sutures for sacrospinous fixation (SSF) in patients with uterovaginal prolapse (pelvic organ prolapse quantification [POP-Q] stage 2 or higher) in terms of postoperative recovery, complications, recurrence of prolapse, and quality of life (QoL). Design/Methods: Patients were randomized into two groups and all patients underwent transvaginal SSF routinely with polyglactin or with PDS II suture irrespective of whether hysterectomy and/or pelvic-floor reconstruction were combined or not. The patients were followed-up for at least till 2 years postoperatively. Cases were excluded if they were lost to follow-up for 2 years after being operated on. Results: There were 80 patients in group 1 and 82 patients in group 2 with uterovaginal prolapse of POP-Q grade 2 or higher. The majority (70/80 in group 1 and 71/82 in group 2) of the cases underwent vaginal hysterectomy (VH) with pelvic floor-repair (PFR) along with SSF. There was no significant difference between the groups in terms of short- or long-term morbidity. The mean follow-up period was 28 months and 95% of these patients reported improved QoL in both groups. Five patients developed asymptomatic cystocoeles in group 1 and 4 developed this condition in group 2. Enterocoeles were detected in 2 cases each in both of the groups. The objective cure rates were 91.25% and 92.68% in the groups, respectively. Conclusions: Extensive data exist regarding SSF, but the search for ideal suture material is still ongoing. The polyglactin suture is equally efficacious, compared to the polydioxanone suture, for decreasing the incidence of future vault prolapse with comparable suture related complications. (J GYNECOL SURG 29:281)