Scholarlink

Introduction and Hypothesis <p>Sacrospinous ligament suspension (SSLS) is a common native-tissue prolapse repair procedure. Although effective, 5-year failure rates can approach 70%. Permanent sutures offer durability but carry risks such as erosion and bleeding. Absorbable sutures may reduce these complications, but their efficacy remains uncertain. We hypothesized that absorbable sutures would be non-inferior to permanent sutures in maintaining apical support at 12&#xa0;months.</p> Methods <p>We conducted a randomized controlled trial from January 2023 to January 2025 at a tertiary center. Patients undergoing SSLS were randomized 1:1 to absorbable or permanent sutures. Blinded assessors evaluated outcomes. The primary outcome was POP-Q point C at 12&#xa0;months. A non-inferiority margin of 2 points in POP-Q point C and standard deviation of 2 were used. Secondary outcomes included composite prolapse recurrence, suture-related complications, and Patient Global Impression of Improvement (PGI-I). To achieve 90% power with α = 0.05, 18 patients per group were required. Fisher’s exact, Mann–Whitney <i>U</i>, and Chi-squared tests were used where appropriate.</p> Results <p>Forty-nine patients were randomized; 41 completed follow-up (23 absorbable, 18 permanent). Median point C was –5 in both groups (<i>p</i> = 0.98). Composite recurrence rates were similar (43.5% absorbable vs 50% permanent, <i>p</i> = 0.68). No suture erosion or granulation was observed. PGI-I improvement in 82.6% of the absorbable and 100% of the permanent group (<i>p</i> = 0.12).</p> Conclusions <p>Absorbable sutures were non-inferior to permanent sutures in supporting apical prolapse at 12&#xa0;months. Both groups demonstrated high rates of patient-reported improvement with low complication rates.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Is Absorbable Suture Non-Inferior to Permanent Suture in Sacrospinous Ligament Suspension? A Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2025年11月26日

查看全文
  • Kaythi Khin,
  • Anastasiya Holubyeva,
  • Tess Gao,
  • Shaun Adair,
  • Erika Wasenda,
  • Carolyn Botros,
  • Ricardo Caraballo,
  • Laura Dhariwal

摘要

Introduction and Hypothesis

Sacrospinous ligament suspension (SSLS) is a common native-tissue prolapse repair procedure. Although effective, 5-year failure rates can approach 70%. Permanent sutures offer durability but carry risks such as erosion and bleeding. Absorbable sutures may reduce these complications, but their efficacy remains uncertain. We hypothesized that absorbable sutures would be non-inferior to permanent sutures in maintaining apical support at 12 months.

Methods

We conducted a randomized controlled trial from January 2023 to January 2025 at a tertiary center. Patients undergoing SSLS were randomized 1:1 to absorbable or permanent sutures. Blinded assessors evaluated outcomes. The primary outcome was POP-Q point C at 12 months. A non-inferiority margin of 2 points in POP-Q point C and standard deviation of 2 were used. Secondary outcomes included composite prolapse recurrence, suture-related complications, and Patient Global Impression of Improvement (PGI-I). To achieve 90% power with α = 0.05, 18 patients per group were required. Fisher’s exact, Mann–Whitney U, and Chi-squared tests were used where appropriate.

Results

Forty-nine patients were randomized; 41 completed follow-up (23 absorbable, 18 permanent). Median point C was –5 in both groups (p = 0.98). Composite recurrence rates were similar (43.5% absorbable vs 50% permanent, p = 0.68). No suture erosion or granulation was observed. PGI-I improvement in 82.6% of the absorbable and 100% of the permanent group (p = 0.12).

Conclusions

Absorbable sutures were non-inferior to permanent sutures in supporting apical prolapse at 12 months. Both groups demonstrated high rates of patient-reported improvement with low complication rates.