In the wake of the now known complications associated with the use of non absorbable material in the management of pelvic floor disorders such as stress incontinence there has been a move towards discussing and giving patients choice between absorbable and non absorbable sutures at colposuspension for stress incontinence. There has been minimal data on the differences at success rates between absorbable and non absorbable sutures during colposuspension and traditionally this procedure has been performed using non absorbable sutures, at our unit prior to Mesh scandal we would use Ethibond. Since pause in insertion of retropubic tapes for stress incontinence, colposuspension surgeries have had a surge. Previous studies and literature reviews is limited with largely comparing use of staples versus permanent sutures. Our study aimed to compare cure rate in those patients who had colposuspension (open or laparoscopic) performed using absorbable sutures and those performed using permanent suture.

This was a retrospective reviews of the operation notes to ascertain suture material used and patient reported resolution of their symptoms at post operative clinic review or reported recurrence of symptoms within the 12 months following the procedure. Failure rate was defined as persistent stress incontinence/ recurrence of stress incontinence within 12 months of the Burch Colposuspension.
The patients cohort was identified from the British Society of Urogynaecologists (BSUG) database as input by the named consultant. A total of 69 patients were identified between 2017 - 2021. Operation notes were sought from the archived hospital database of clinical notes, current electronic operative notes and patients's written notes. We are yet to review all the notes therefore unable to fully report our results prior to the deadline for the this abstract.

Preliminary results appear to show higher failure rate when absorbable suture material was used during the operation with an initial cure rate and a later reported complete recurrence of stress incontinence within the first 6 months after Burch Colposuspension was performed. There also appeared to be a slight higher rate of failure with laparoscopic colposuspension in comparison to the open approach.

The full results of our analysis is yet to be completed but there is suggestion that permanent (non-absorbable) sutures may be superior in achieving the success rates that are normally quoted for colposuspension (85% success rates) at 12 months. The data on permanent suture material migration for Burch colposuspension is very scanty leading to the conclusion whether use of absorbable material confers additional benefit.

It is difficult to fully analyse our results as analysis of the notes is ongoing and although we have seen some differences in the success rates we are aware that this is not a randomised control study and our data and results may be surgeon specific but nonetheless when there is ongoing discussions with regards to use of permanent suture materials and the long term effects reported by many women, our small scale study hopes to open discussions and more research so as to give women more informed choices when deciding on incontinence surgery.

Smits-Braat, M., Vierhout, M.E. Permanent or absorbable sutures for Burch colposuspension?. Int Urogynecol J 6, 350–352 (1995). https://doi.org/10.1007/BF01892744  Download citation
Zullo F, Palomba S, Russo T, Sbano FM, Falbo A, Morelli M, Pellicano M, Mastrantonio P. Laparoscopic colposuspension using sutures or prolene meshes: a 3-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2004 Dec 1;117(2):201-3. doi: 10.1016/j.ejogrb.2004.04.030. PMID: 15541858.
Lapitan MC, Cody JD, Grant A. Open retropubic colposuspension for urinary incontinence in women: a short version Cochrane review. Neurourol Urodyn. 2009;28(6):472-80. doi: 10.1002/nau.20780. PMID: 19591206.

Continence 2S2 (2022) 100348
DOI: 10.1016/j.cont.2022.100348