Comparative study of absorbable suture and permanent suture in sacrocolpopexy: a meta-analysis and systematic review

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.