title: A pilot study comparing anatomic failure after sacrocolpopexy with absorbable or permanent sutures for vaginal mesh attachment.
abstract: OBJECTIVE
  To describe anatomic failure rates for sacrocolpopexy in groups receiving either delayed absorbable or permanent monofilament suture for mesh attachment to the vagina.
  
  
  METHODS
  We reviewed the medical records of 193 women who underwent sacrocolpopexy with 2 different types of sutures attaching polypropylene mesh to the vagina: delayed absorbable sutures (median follow-up, 43 weeks) and permanent sutures (median follow-up, 106 weeks). Vaginal apical failure was defined as Point C greater than or equal to half of the total vaginal length. Anterior-posterior compartmental failures were defined as Point Ba and/or Point Bp more than 0 cm. Fisher exact and χ2 tests were used to compare failure rates. There were no documented suture erosions in the delayed absorbable monofilament suture group during the review period. Two patients in the permanent suture group were found to have permanent suture in the bladder more than 30 weeks after the index procedure.
  
  
  RESULTS
  Failure rates for the 45 subjects in the delayed absorbable group and 148 subjects in the permanent suture group were similar (4.4% vs 3.4%, p = 0.74) and not statistically different in any compartment: apical (0% vs 1.4%, p = 0.43), anterior (4.4% vs 2%, p = 0.38), or posterior (0% vs 1.4%, p = 0.43).
  
  
  CONCLUSIONS
  Delayed absorbable monofilament suture appears to be a reasonable alternative to permanent suture for mesh attachment to the vagina during sacrocolpopexy. The use of delayed absorbable suture could potentially prevent complications of suture erosion into the bladder or vagina remote from the time of surgery.
authors: Female Pelvic Medicine and Reconstructive Surgeon at the Kaiser Permanente San Diego Medical Center in CA. jasmine.tankim@gmail.com.
authors: Jasmine
authors: J
authors: Tan-Kim
authors: Division Chief in Female Pelvic Medicine and Reconstructive Surgery at the Kaiser Permanente San Diego Medical Center in CA. shawn.a.menefee@kp.org.
authors: Shawn A
authors: SA
authors: Menefee
authors: Female Pelvic Medicine and Reconstructive Surgery Fellow at the University of California, San Diego and the Kaiser Permanente San Diego Medical Center. qlippmann@ucsd.edu.
authors: Quinn
authors: Q
authors: Lippmann
authors: Fellowship Director for Female Pelvic Medicine and Reconstructive Surgery at the University of California, San Diego. elukacz@ucsd.edu.
authors: Emily S
authors: ES
authors: Lukacz
authors: Female Pelvic Medicine and Reconstructive Surgeon at the Kaiser Permanente San Diego Medical Center in CA. karl.m.luber@kp.org.
authors: Karl M
authors: KM
authors: Luber
authors: Division Chief for Female Pelvic Medicine and Reconstructive Surgery at the University of California, San Diego. cnager@ucsd.edu.
authors: Charles W
authors: CW
authors: Nager
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D013526:Surgical Mesh; D013537:Sutures; D017211:Treatment Failure; D014596:Uterine Prolapse / Q000601:surgery*