title: Does the choice of suture material matter in anterior and posterior colporrhaphy?
abstract: OBJECTIVE
  The optimal suture material in traditional prolapse surgery is still controversial. Our aim was to investigate the effect of using sutures with rapid (RA) or slow (SA) absorption, on symptomatic recurrence after anterior and posterior colporrhaphy.
  
  
  METHODS
  A population-based longitudinal cohort study with data from the Swedish National Quality Register for Gynecological Surgery. A total of 1,107 women who underwent primary anterior colporrhaphy and 577 women who underwent primary posterior colporrhaphy between September 2012 and September 2013 were included. Two groups in each cohort were created based on which suture material was used. Pre- and postoperative prolapse-related symptoms and patient satisfaction were assessed.
  
  
  RESULTS
  We found a significantly lower rate of symptomatic recurrence 1 year after anterior colporrhaphy in the SA suture group compared with the RA suture group, 50 out of 230 (22 %) vs 152 out of 501 (30 %), odds ratio 1.6 (CI 1.1-2.3; p = 0.01). The SA group also had a significantly higher patient satisfaction rate, 83 % vs 75 %, odds ratio 1.6 (CI 1.04-2.4), (p = 0.03). Urgency improved significantly more in the RA suture group (p < 0.001). In the posterior colporrhaphy cohort there was no significant difference between the suture materials.
  
  
  CONCLUSIONS
  This study indicates that the use of slowly absorbable sutures decreases the odds of having a symptomatic recurrence after an anterior colporrhaphy compared with the use of rapidly absorbable sutures. However, the use of RA sutures may result in less urgency 1 year postoperatively. In posterior colporrhaphy the choice of suture material does not affect postoperative symptoms.
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and the Division of Obstetrics and Gynecology at Södersjukhuset, 11832 Södersjukhuset, Stockholm, Sweden. ida.bergman@sodersjukhuset.se.
authors.forename: Ida
authors.identifier: http://orcid.org/0000-0002-5515-5953
authors.initials: I
authors.lastname: Bergman
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and the Division of Obstetrics and Gynecology at Södersjukhuset, 11832 Södersjukhuset, Stockholm, Sweden.
authors.forename: Marie Westergren
authors.initials: MW
authors.lastname: Söderberg
authors.affiliation: Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Kjaeldgaard
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and the Division of Obstetrics and Gynecology at Södersjukhuset, 11832 Södersjukhuset, Stockholm, Sweden.
authors.forename: Marion
authors.initials: M
authors.lastname: Ek
mesh_terms: D065966:Absorption, Physicochemical; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D013536:Suture Techniques; D013537:Sutures; D013548:Sweden; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*
keywords: Anterior colporrhaphy; Pelvic organ prolapse; Posterior colporrhaphy; Recurrence; Suture material