title: Permanent suture used in uterosacral ligament suspension offers better anatomical support than delayed absorbable suture.
abstract: OBJECTIVE
  The objective of this study was to compare the outcomes of uterosacral ligament suspension (USLS) procedures in relation to suture material used for apical suspension.
  
  
  METHODS
  A retrospective chart review was performed for two senior surgeons who supervised and performed USLS with both suture types in 2008-2009. Permanent and delayed absorbable sutures were compared for failure of anatomical support. Failure, defined as recurrent prolapse beyond the hymen, was evaluated using survival analysis.
  
  
  RESULTS
  Two hundred forty-eight procedures were performed. One percent in the permanent group had a loss of support beyond the hymen compared to 6% in the delayed absorbable group (p = 0.034). The preoperative prolapse stage and duration of follow-up did not differ between the two groups. The number of sutures used did not differ between patients who failed and those who did not fail.
  
  
  CONCLUSIONS
  The use of permanent sutures for USLS of the vaginal apex was associated with a lower failure rate than delayed absorbable sutures in the short-term.
authors: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Scott and White Healthcare/Texas A&M Health Science Center College of Medicine, 2401 South 31st Street, Temple, TX 76508, USA. cchung@swmail.sw.org
authors: Christopher P
authors: CP
authors: Chung
authors: Richard
authors: R
authors: Miskimins
authors: Thomas J
authors: TJ
authors: Kuehl
authors: Paul M
authors: PM
authors: Yandell
authors: Bobby L
authors: BL
authors: Shull
mesh_terms: D000368:Aged; D001672:Biocompatible Materials; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000473:pathology* / Q000601:surgery*; D016687:Polydioxanone / Q000009:adverse effects*; D011091:Polyesters / Q000009:adverse effects*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013536:Suture Techniques; D013537:Sutures / Q000009:adverse effects*; D017211:Treatment Failure
chemical_list: D001672:Biocompatible Materials; D011091:Polyesters; D016687:Polydioxanone