Does use of permanent suture material affect outcome of the modified Pereyra procedure?
OBJECTIVE
To determine the effect of absorbable versus permanent suture on outcome of the modified Pereyra procedure for stress urinary incontinence.


METHODS
A review was performed of case-series reports of outcome of the modified Pereyra procedure for stress urinary incontinence that provided at least 1 year of follow-up and that specified the suture material used. Outcomes of cases in which permanent suture was used were compared with cases in which absorbable suture was used. The groups were further stratified according to whether success of the procedure was determined objectively or subjectively. Chi-square analysis was performed.


RESULTS
Fourteen case-series reports were examined, representing a total of 988 modified Pereyra operations. Overall, the relative risk (RR) of failure when absorbable suture was used was 1.8 times higher than with permanent suture (95% confidence interval [CI] 1.4-2.3; P < .0001) using objective or subjective outcome criteria. The RR of failure using absorbable suture when judged by objective criteria only was 1.6 (95% CI 1.1-2.3; P = .03) and when judged by subjective outcome only was 2.3 (95% CI 1.5-3.4; P < .0001).


CONCLUSIONS
Until a randomized controlled trial is done, the available evidence supports the use of permanent suture material whenever the modified Pereyra procedure is performed.
Korn
A P
AP
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA.
D006801:Humans; D013536:Suture Techniques; D013537:Sutures; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery*