Abstract：
OBJECTIVE: To evaluate success and safety of sacrospinous ligament fixation (SSLF) using permanent versus absorbable suture materials 12 months following surgery.
METHODS: Following IRB approval, the electronic medical records of women who underwent SSLF in the gynecology department of a university-affiliated medical center from November 2012 to September 2021 were retrospectively reviewed. SSLF was carried out using Capio®and Digitex™, with either absorbable (polyglactin-910 or polydioxanone) sutures (group 1), or permanent (polypropylene) sutures (group 2), Pre-operative and post-operative assessment included prolapse staging using the pelvic organ prolapse quantification system and validated quality of life questionnaires (Pelvic Floor Distress Inventory and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12). Patients with postoperative information on objective and subjective outcome at 12 months were included in final analysis. Anatomical success was defined as POP stage < 2 at 12-months following surgery. For statistical analysis, the Mann-Whitney test was used for continuous variables, Fisher\'s exact test for dichotomous variables, and Chi-squared test of independence for variables with>2 categories.
RESULTS: During the study period, 234 women underwent SSLF. One-hundred and forty-two patients (60.7 %) returned at the 12-month follow-up and were included in final analysis. Seventy-two (50.7 %) patients had absorbable suture and 70 patients (49.3 %) had permanent suture. Estimated blood loss was significantly higher in group 1 [100 (50-150) cc vs 50 (50-100) cc respectively, p =.016]. Moderate to severe pain on POD-1 was significantly higher in group 2 [VAS: 2.00 (0.00-4.00) vs 4.00 (3.00-5.75) respectively, p =.001]. Anatomical success, defined as POP ≤ stage 2 at 12 months, was similar between groups: 69 % in group 1 vs 67 % in group 2 (p =.77). Subjective cure was similar between groups, 97.2 % in group 1 vs 94.3 % in group 2 (p =.44). At the 12-month follow-up, none of the patients had gluteal pain. The rate of de-novo dyspareunia was similar between groups: 4 women (5.9 %) in the absorbable suture group versus 2 women (3.3 %) in the permanent suture group (p =.49).
CONCLUSIONS: Our findings suggest that absorbable or permanent suture material does not affect outcome of SSLF. Permanent sutures may be related to increased immediate postoperative pain.
METHODS: Following IRB approval, the electronic medical records of women who underwent SSLF in the gynecology department of a university-affiliated medical center from November 2012 to September 2021 were retrospectively reviewed. SSLF was carried out using Capio®and Digitex™, with either absorbable (polyglactin-910 or polydioxanone) sutures (group 1), or permanent (polypropylene) sutures (group 2), Pre-operative and post-operative assessment included prolapse staging using the pelvic organ prolapse quantification system and validated quality of life questionnaires (Pelvic Floor Distress Inventory and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12). Patients with postoperative information on objective and subjective outcome at 12 months were included in final analysis. Anatomical success was defined as POP stage < 2 at 12-months following surgery. For statistical analysis, the Mann-Whitney test was used for continuous variables, Fisher\'s exact test for dichotomous variables, and Chi-squared test of independence for variables with>2 categories.
RESULTS: During the study period, 234 women underwent SSLF. One-hundred and forty-two patients (60.7 %) returned at the 12-month follow-up and were included in final analysis. Seventy-two (50.7 %) patients had absorbable suture and 70 patients (49.3 %) had permanent suture. Estimated blood loss was significantly higher in group 1 [100 (50-150) cc vs 50 (50-100) cc respectively, p =.016]. Moderate to severe pain on POD-1 was significantly higher in group 2 [VAS: 2.00 (0.00-4.00) vs 4.00 (3.00-5.75) respectively, p =.001]. Anatomical success, defined as POP ≤ stage 2 at 12 months, was similar between groups: 69 % in group 1 vs 67 % in group 2 (p =.77). Subjective cure was similar between groups, 97.2 % in group 1 vs 94.3 % in group 2 (p =.44). At the 12-month follow-up, none of the patients had gluteal pain. The rate of de-novo dyspareunia was similar between groups: 4 women (5.9 %) in the absorbable suture group versus 2 women (3.3 %) in the permanent suture group (p =.49).
CONCLUSIONS: Our findings suggest that absorbable or permanent suture material does not affect outcome of SSLF. Permanent sutures may be related to increased immediate postoperative pain.
摘要：
目的：评估术后12个月使用永久性和可吸收缝合材料固定骶棘韧带（SSLF）的成功和安全性。
方法：在IRB批准后，我们对2012年11月至2021年9月在一所大学附属医疗中心妇科接受SSLF治疗的女性的电子病历进行了回顾性分析.SSLF使用Capio®和Digitex™进行，使用可吸收（polyglactin-910或聚二恶烷酮）缝线（第1组），或永久性（聚丙烯）缝线（第2组），术前和术后评估包括使用盆腔器官脱垂量化系统进行脱垂分期和经过验证的生活质量问卷（盆底窘迫量表和盆腔器官脱垂/尿失禁性问卷-12）。最终分析包括术后12个月时客观和主观结果的患者。解剖学成功定义为术后12个月POP分期<2。为了进行统计分析，Mann-Whitney检验用于连续变量，费舍尔对二分变量的精确检验，>2类变量的独立性和卡方检验。
结果：在研究期间，234名女性接受了SSLF。在12个月的随访中，有142例患者（60.7％）返回，并纳入最终分析。72例（50.7%）患者使用可吸收缝线，70例（49.3%）患者使用永久性缝线。第1组[100(50-150)cc比50(50-100)cc的估计失血量明显较高，p=.016]。第2组POD-1的中度至重度疼痛明显增高[VAS:2.00(0.00-4.00)vs4.00(3.00-5.75),p=.001]。解剖学上的成功，定义为12个月时的POP≤阶段2，组间相似：第1组为69%，第2组为67%（p=0.77）。两组之间的主观治愈相似，第一组为97.2%，第二组为94.3%（p=0.44）。在12个月的随访中，没有患者出现臀痛。两组之间的新性交困难发生率相似：可吸收缝线组4名女性（5.9％）与永久性缝线组2名女性（3.3％）（p=.49）。
结论：我们的研究结果表明，可吸收或永久性缝合材料不会影响SSLF的预后。永久性缝合可能与术后即刻疼痛增加有关。
方法：在IRB批准后，
结果：在研究期间，
结论：我们的研究结果表明，可吸收或永久性缝合材料不会影响SSLF的预后。
