Nonabsorbable Versus Delayed-Absorbable Sutures in Vaginal Uterosacral Ligament Suspension: A Retrospective Cohort Study

Abstract Introduction and Hypothesis The optimal suture material for uterosacral ligament suspension (USLS) remains uncertain. We compared surgical outcomes between nonabsorbable and delayed-absorbable sutures in vaginal USLS. Methods This retrospective cohort study included patients who underwent vaginal hysterectomy with USLS for uterine prolapse and completed 1-year follow-up. The primary outcome was composite surgical failure at 1 year, defined as vaginal bulge symptoms, apical descent greater than half of the total vaginal length, anterior or posterior descent beyond the hymen, or retreatment for prolapse. Secondary outcomes included suture-related complications and need for intervention. Results A total of 310 patients were included (205 nonabsorbable, 105 delayed-absorbable). Composite surgical failure was significantly higher in the delayed-absorbable group (38.1% vs 13.7%, p < 0.01). Overall suture-related complication rates did not differ significantly ( p = 0.28), whereas complications requiring intervention were less frequent in the delayed-absorbable group (1.0% vs 5.9%, p = 0.04). Conclusions Delayed-absorbable sutures were associated with higher surgical failure but fewer complications requiring intervention compared with nonabsorbable sutures.