An Alternative Approach to Posterior Colporrhaphy Plication Using Delayed Absorbable Unidirectional Barbed Suture

He, Shasha; Falk, Kerac N; Kannan, Akshaya; Kelley, Robert S.

doi:10.1097/spv.0000000000000828

Cited by 1 publication

(6 citation statements)

References 14 publications

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“…Finally, our anatomic recurrence rates for posterior compartment prolapse were 6 weeks (0%) and 12 months (1.9%), which are comparable with previously published studies with high 1-year anatomic cure rates after posterior repair 2,36 . Subjective recurrence rates after suture based posterior repairs range from 7% to 33%, and our study again found low subjective recurrence rates at 6 weeks (0%), 6 months (4.6%), and 12 months (3.8%) 15,37 . Although a significant decrease in surgical time has been described when comparing barbed suture with conventional suture, we did not find a statistical difference in total surgical time between suture type for posterior repair 12,38 …”

Section: Discussionsupporting

confidence: 90%

“…2,36 Subjective recurrence rates after suture based posterior repairs range from 7% to 33%, and our study again found low subjective recurrence rates at 6 weeks (0%), 6 months (4.6%), and 12 months (3.8%). 15,37 Although a significant decrease in surgical time has been described when comparing barbed suture with conventional suture, we did not find a statistical difference in total surgical time between suture type for posterior repair. 12,38 After completion of the study, attending physicians and fellows were surveyed.…”

Section: Discussioncontrasting

confidence: 70%

“…Our randomized control trial is one of the few studies evaluating the suture type used for posterior repairs and is the only comparative trial using barbed suture. There is a single case series evaluating barbed suture used for posterior repairs; however, study design did not allow for evaluation of postoperative pain, dyspareunia, or operative times 15 Postoperative pain and sexual dysfunction are a concern when managing posterior compartment defects surgically. We found that intraoperative suture burden was 50% less in the barbed suture group, which may help decrease inflammation and subsequent pain n ORIGINAL RESEARCH Barbed vs Nonbarbed Suture with suture resorption.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] A recent retrospective case series reported good 1-year anatomic cure rates with low postoperative complications using barbed suture for posterior repairs. 15,16 This begs the question, can suture type effect postoperative patient outcomes? Therefore, for this study, we decided to evaluate barbed suture with a primary outcome of postoperative pain at 6 weeks, because this is when a patient would resume all activities, including intercourse if sexually active.…”

Section: Why This Mattersmentioning

confidence: 99%

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Barbed Versus Nonbarbed Suture for Posterior Colporrhaphy: A Randomized Controlled Trial

Merriman,

Burrell,

Winn

et al. 2024

UROGC

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Importance There is limited literature or even consensus on the suture material used for posterior vaginal repairs. Objectives This study aimed to compare outcomes of barbed versus nonbarbed delayed absorbable suture used for posterior colporrhaphy. Study Design This study conducted a randomized controlled trial of 72 women undergoing posterior repair using standardized technique—concurrent procedures permitted with barbed (n = 36) or nonbarbed (n = 36) suture. Standardized examinations, validated questionnaires, and a visual analog scale (VAS) were completed at baseline, 6 weeks, and 12 months, and a telephone interview was conducted at 6 months. The primary outcome was posterior compartment pain at 6 weeks, measured by a VAS. Results Seventy-two women enrolled, with follow-up rates 6 weeks (100%), 6 months (90.3%), and 12 months (73.6%). Demographics were similar between groups. A VAS with movement was not different between groups at 6 weeks. The odds of experiencing vaginal pain, having myofascial pain on examination, or being sexually active postoperatively were not different between the groups. There were no differences in the length of posterior colporrhaphy, surgical times, or hospital length of stay between the groups. Suture passes were lower in the nonbarbed group (median, 4 vs 7; P = <0.001), and suture burden was higher in the nonbarbed group (median, 26.9 vs 10.5 cm; P = <0.001). There was overall improvement in Pelvic Floor Distress Inventory Short Form 20 prolapse and colorectal subscores but no differences between groups. Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form 12 scores improved, and dyspareunia decreased at 6 and 12 months in both groups. In addition, there were few anatomic recurrences at 6 weeks (0%) and 12 months (3.4%) and few adverse events. Conclusions This study found no differences in primary or secondary outcomes; however, both suture types resulted in clinical improvements in quality-of-life measures and sexual function.

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Section: Discussionsupporting

confidence: 90%