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

Autor:	Merriman AL; From the Ascension Medical Group Saint Thomas Center for Female Pelvic Medicine, Nashville, TN., Burrell AD; Division of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA., Winn H; Division of Urogynecology and Pelvic Surgery, Department of Obstetrics and Gynecology., Anderson WE; Center for Outcomes Research and Evaluation, Atrium Health, Charlotte, NC., Tarr ME; Division of Urogynecology and Pelvic Surgery, Department of Obstetrics and Gynecology., Myers EM; Division of Urogynecology and Pelvic Surgery, Department of Obstetrics and Gynecology.
Jazyk:	angličtina
Zdroj:	Urogynecology (Philadelphia, Pa.) [Urogynecology (Phila)] 2024 Aug 01; Vol. 30 (8), pp. 721-731. Date of Electronic Publication: 2024 Jan 12.
DOI:	10.1097/SPV.0000000000001450
Abstrakt:	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. Competing Interests: The authors have declared they have no conflicts of interest. (Copyright © 2024 American Urogynecologic Society. All rights reserved.)
Databáze:	MEDLINE
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