Vaginal Sacrospinous Ligament Fixation: Outcomes of Absorbable Compared to Permanent Suture

Introduction: Suture type is thought to influence prolapse recurrence following sacrospinous ligament fixation (SSLF), but comparative data between absorbable and permanent suture remains sparse. This study aimed to compare prolapse recurrence rates after SSLF using absorbable versus permanent suture, hypothesizing no difference in outcomes. Materials and Methods: We conducted a retrospective cohort study of women who underwent vaginal SSLF from January 2017 to June 2021 at a single institution. We compared two groups: (1) absorbable suspension suture (Maxon or polydiaxanone) (2) permanent suspension suture (prolene). Our primary outcome was composite prolapse recurrence, defined as (1) anatomical failure (recurrent prolapse in any compartment past the hymen) and/or (2) retreatment for prolapse with either surgery or pessary at the most recent pelvic exam. Results: Our cohort was composed of 152 women, of whom 47.4% ( n = 72) underwent SSLF with only delayed absorbable suture and 80 (52.6%) with permanent suture. Overall, there were no differences between the two groups in composite prolapse recurrence (11.1% vs. 22.5%, p = 0.06), anatomical failure (6.9% vs. 16.3%, p = 0.08), or retreatment (4.2% vs. 5.0%, p = 0.82) at a median of 217.5 days of follow-up. There was no difference in postoperative complications between groups (32.4% vs. 33.8%, p = 0.86). When adjusting for differential characteristics, hazard ratios of composite prolapse recurrence were similar between suture groups (adjusted hazard ratio: 0.52; confidence interval [CI]: 0.18–1.49; p = 0.22). Conclusions: Vaginal SSLF with delayed absorbable suture demonstrates similar durability to permanent suture in terms of prolapse recurrence.