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An Alternative Approach to Posterior Colporrhaphy ...
An Alternative Approach to Posterior Colporrhaphy Plication using Delayed Absorbable Unidirectional Barbed Suture - Siping He, MD
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This study aims to report on the use of delayed absorbable unidirectional barbed sutures for posterior colporrhaphy in 82 patients. The traditional method of posterior colporrhaphy involves plication of the rectovaginal fascia with interrupted sutures, which can lead to complications such as slippage, decreased tensile strength, and tissue inflammation. The hypothesis of this study is that using the barbed sutures will result in excellent anatomic cure, low rates of repeat operation, and low rates of post-surgical complications at the 6-week and 1-year follow-up. <br /><br />The method for posterior colporrhaphy in this study involves hydrodissection of the vaginal epithelium, sharp split thickness dissection of the vaginal epithelium from underlying muscle/fascia, and plication of the vaginal epithelium with the barbed sutures. <br /><br />Results from the study show favorable outcomes, with no reported cases of repeat operation for isolated failed posterior repair. However, one patient had an anatomic cure at 6 weeks but experienced complete vaginal vault eversion within one year. Another patient had a perineocele at 1 year and underwent repeat posterior repair and perineorrhaphy. <br /><br />Overall, this small case series suggests that using delayed absorbable unidirectional barbed sutures for posterior colporrhaphy may be a viable alternative approach with favorable outcomes. However, a prospective trial is needed to further evaluate the outcomes of this method compared to traditional posterior colporrhaphy.
Keywords
delayed absorbable unidirectional barbed sutures
posterior colporrhaphy
complications
anatomic cure
repeat operation
post-surgical complications
hydrodissection
vaginal epithelium
sharp split thickness dissection
favorable outcomes
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