INTRODUCTION AND HYPOTHESIS: We aimed to determine if the use of permanent suture for the apical fixation during traditional anterior colporrhaphy results in improved outcomes compared to delayed absorbable suture. METHODS: A retrospective case-control study was performed in patients who underwent traditional non-grafted anterior colporrhaphy with reattachment of the anterior endopelvic fascia to the apex/cervix comparing permanent (group 1) or absorbable suture (group 2). Patients were matched based on age, body mass index, and presenting stage of prolapse. The primary outcome assessed was anterior wall vaginal prolapse recurrence defined as Pelvic Organ Prolapse Quantification (POP-Q) points Aa or Ba ≥ -1 cm. Secondary outcome measures included overall prolapse stage, subjective reporting of satisfaction, and any healing abnormalities or complications resulting from suture type. RESULTS: A total of 230 patients were reviewed (80 in group 1 and 150 in group 2) and median follow-up was 52 (24-174) weeks. A statistically significant improvement in anterior wall anatomy was seen in group 1 compared to group 2 [(Aa -2.70 ± 0.6 cm vs -2.5 ± 0.75 cm, p = 0.02) and Ba (-2.68 ± 0.65 cm vs -2.51 ± 0.73 cm, p = 0.03), respectively]. Comparing prolapse stage, there were no observed differences between the groups. Exposure of the permanent suture occurred in 12 patients (15 %) and 5 (6.5 %) required suture trimming to treat the exposure. CONCLUSIONS: Reattachment of endopelvic fascia to the apex at the time of anterior colporrhaphy results in low recurrence rates. Use of permanent suture for apical fixation is associated with improved anatomic correction at the expense of increased suture exposures.
INTRODUCTION AND HYPOTHESIS: We aimed to determine if the use of permanent suture for the apical fixation during traditional anterior colporrhaphy results in improved outcomes compared to delayed absorbable suture. METHODS: A retrospective case-control study was performed in patients who underwent traditional non-grafted anterior colporrhaphy with reattachment of the anterior endopelvic fascia to the apex/cervix comparing permanent (group 1) or absorbable suture (group 2). Patients were matched based on age, body mass index, and presenting stage of prolapse. The primary outcome assessed was anterior wall vaginal prolapse recurrence defined as Pelvic Organ Prolapse Quantification (POP-Q) points Aa or Ba ≥ -1 cm. Secondary outcome measures included overall prolapse stage, subjective reporting of satisfaction, and any healing abnormalities or complications resulting from suture type. RESULTS: A total of 230 patients were reviewed (80 in group 1 and 150 in group 2) and median follow-up was 52 (24-174) weeks. A statistically significant improvement in anterior wall anatomy was seen in group 1 compared to group 2 [(Aa -2.70 ± 0.6 cm vs -2.5 ± 0.75 cm, p = 0.02) and Ba (-2.68 ± 0.65 cm vs -2.51 ± 0.73 cm, p = 0.03), respectively]. Comparing prolapse stage, there were no observed differences between the groups. Exposure of the permanent suture occurred in 12 patients (15 %) and 5 (6.5 %) required suture trimming to treat the exposure. CONCLUSIONS: Reattachment of endopelvic fascia to the apex at the time of anterior colporrhaphy results in low recurrence rates. Use of permanent suture for apical fixation is associated with improved anatomic correction at the expense of increased suture exposures.
Authors: Christopher P Chung; Richard Miskimins; Thomas J Kuehl; Paul M Yandell; Bobby L Shull Journal: Int Urogynecol J Date: 2011-09-03 Impact factor: 2.894
Authors: P K Sand; S Koduri; R W Lobel; H A Winkler; J Tomezsko; P J Culligan; R Goldberg Journal: Am J Obstet Gynecol Date: 2001-06 Impact factor: 8.661
Authors: R P Goldberg; S Koduri; R W Lobel; P J Culligan; J E Tomezsko; H A Winkler; P K Sand Journal: Am J Obstet Gynecol Date: 2001-12 Impact factor: 8.661
Authors: Cheryl B Iglesia; Andrew I Sokol; Eric R Sokol; Bela I Kudish; Robert E Gutman; Joanna L Peterson; Susan Shott Journal: Obstet Gynecol Date: 2010-08 Impact factor: 7.661
Authors: Guri Rortveit; Jeanette S Brown; David H Thom; Stephen K Van Den Eeden; Jennifer M Creasman; Leslee L Subak Journal: Obstet Gynecol Date: 2007-06 Impact factor: 7.661
Authors: Danielle D Antosh; Ladin A Yurteri-Kaplan; David Shveiky; Madalena Liu; Chris Heisler; Aparna Hegde; Cara L Grimes Journal: Int Urogynecol J Date: 2019-04-29 Impact factor: 2.894
Authors: Jeffrey S Schachar; Hemikaa Devakumar; Laura Martin; Sara Farag; Eric A Hurtado; G Willy Davila Journal: Int Urogynecol J Date: 2018-03-19 Impact factor: 2.894