Medium-Term Anatomical and Functional Results of Isolated Laparoscopic Sacrocolpopexy for Female Pelvic Organ Prolapse during the Early Learning Curve

Shekhar, Shashank; Goyal, Shuchita; Goel, Manu; Sharma, Charu; Jhirwal, Manisha

doi:10.1007/s13224-020-01373-x

Cited by 2 publications

(1 citation statement)

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“…Thirty-nine studies with 3,349 patients met inclusion criteria for the sacrocolpopexy category. Three compared both suture types, 9,39,40 and 36 used one suture type (20 permanent 41–60 and 16 absorbable 8,61–75 ); 2,045 patients underwent sacrocolpopexy with permanent suture, and 1,304 with absorbable suture. Overall, nine studies were RCTs, 12 were comparative (two prospective, nine retrospective, one unclear direction), and 18 were single-arm (six prospective, 12 retrospective).…”

Section: Resultsmentioning

confidence: 99%

Permanent Compared With Absorbable Suture in Apical Prolapse Surgery

Pollack

Popiel

Toaff

et al. 2023

Obstetrics &Amp; Gynecology

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To explore how permanent compared with absorbable suture affects anatomic success in native tissue vaginal suspension (uterosacral ligament suspension and sacrospinous ligament suspension) and sacrocolpopexy with mesh.DATA SOURCES: MEDLINE, EMBASE, and ClinicalTrials. gov were searched through March 29, 2022. METHODS OF STUDY SELECTION:Our population included women undergoing apical prolapse surgery (uterosacral ligament suspension and sacrospinous ligament suspension and abdominal sacrocolpopexy). Our intervention was permanent suture for apical prolapse surgery, and our comparator was absorbable suture. We determined a single anatomic success proportion per study. Adverse events collected included suture and mesh exposure, surgery for suture and mesh complication, dyspareunia, and granulation tissue. Abstracts were doubly screened, fulltext articles were doubly screened, and accepted articles were doubly extracted. Quality of studies was assessed using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. In single-arm studies using either permanent or absorbable suture, random effects meta-analyses of pooled proportions were used to assess anatomic success. In comparative studies investigating both suture types, random effects meta-analyses of pooled risk ratios were used.TABULATION, INTEGRATION, AND RESULTS: Of 4,658 abstracts screened, 398 full-text articles were assessed and 63 studies were included (24 vaginal suspension [13 uterosacral ligament suspension and 11 sacrospinous ligament suspension] and 39 sacrocolpopexy). At 2-year follow-up, there was no difference in permanent compared with absorbable suture in uterosacral ligament suspension and sacrospinous ligament suspension (proportional anatomic success rate 88% [95% CI 0.81-0.93] vs 88% [95% CI 0.82-0.92]). Similarly, at 18-month follow-up, there was no difference in permanent compared with absorbable suture in sacrocolpopexy (proportional anatomic success rate 92% [95% CI 0.88-0.95] vs 96% [95% CI 0.92-0.99]). On metaanalysis, there was no difference in relative risk (RR) of success for permanent compared with absorbable suture for uterosacral ligament suspension and sacrospinous ligament suspension (RR 1.11, 95% CI 0.93-1.33) or sacrocolpopexy (RR 1.00, 95% CI0.98-1.03). CONCLUSION: Success rates were similarly high for absorbable and permanent suture after uterosacral ligament suspension, sacrospinous ligament suspension, and sacrocolpopexy, with medium-term follow-up.

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Section: Resultsmentioning

confidence: 99%