Abstract
Introduction and hypothesis
The aim of this study was to compare the surgical results and the complications of absorbable suture (AS) versus permanent suture (PS) in sacrocolpopexy (SCP).
Methods
We systematically searched PubMed, Embase, ClinicalTrials.gov, and the Cochrane Library Central Register of Controlled Trials for articles in which researchers compared AS with PS in SCP. The primary outcomes were the surgical success rate and suture-related complications (suture exposure/erosion, mesh erosion, and suture removal). All analyses were performed with Review Manager 5.3.
Results
Four articles involving 689 patients were ultimately included. Our findings demonstrated that AS had similar surgical success rates to those of PS (OR=1.34; 95% CI, 0.60–2.96) and no significant differences in failure rates were noted between the two groups (OR=0.75; 95% CI, 0.34–1.66). Subgroup analyses in patients with anatomical failure revealed no significant differences in recurrent posterior prolapse (OR=0.33; 95% CI, 0.05–2.10) or in recurrent apical (OR=0.64; 95% CI, 0.03–13.66) or anterior prolapse (OR=0.45; 95% CI, 0.13–1.57). However, the AS group were at a lower risk of suture exposure/erosion (OR=0.18; 95% CI, 0.06–0.58) and a lower suture removal rate (OR=0.14; 95% CI, 0.03–0.61) and retreatment (OR=0.36; 95% CI, 0.16–0.82), but the mesh erosion was not significantly different (OR=1.00; 95% CI, 0.49–2.08).
Conclusions
The data showed that AS had a similar success rate, less exposure/erosion, and were less likely to be removed and require retreatment than PS, which supported the notion that AS is as effective as PS but safer.
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Acknowledgements
This study was supported by the National Key Research and Development Program of China (No. 2021YFC2009100), Natural Science Foundation of China (No.8177063), Huohua Project of Sichuan University (2018), and 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZY2017310).
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Shuang Chen: conceptualization, methodology, data extraction, data analysis, writing original draft preparation; Yuhao Liu: data extraction, data analysis, writing original draft preparation; Liao Peng: data extraction, data analysis; Yuanzhuo Chen: discussion and data extraction; Hong Shen: discussion and data extraction; Deyi Luo: supervision.
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Chen, S., Liu, Y., Peng, L. et al. Comparative study of absorbable suture and permanent suture in sacrocolpopexy: a meta-analysis and systematic review. Int Urogynecol J 34, 993–1000 (2023). https://doi.org/10.1007/s00192-022-05427-8
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DOI: https://doi.org/10.1007/s00192-022-05427-8