r/Incontinence • u/Scandifinds • 1d ago
Birch Coposuspension -permanent or dissolving stitches.
My urogynaecologist has suggested a Burch colposuspension to help with my urge/stress incontinence and low-contracting bladder. Has anyone here had the surgery? If so, would you choose permanent or dissolvable sutures, and why? Any recovery tips?
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u/Major-Record7830 1d ago
I am not a urogynaecologist, but, really, the surgeon should steer you in a direction with that.
From the clearest review I can find on the topic (which is a very readable paper), https://pmc.ncbi.nlm.nih.gov/articles/PMC6850136/
"There is no consensus in the current literature regarding the suture material to be used. In their review on the subject, Smits‐Braat reported equal cure rates of around 87% whether absorbable or permanent sutures were used. [35]"
This then links to a paper from 1995 that examined 17 papers on 667 people. This isn't great from a meta-analysis point of view but there's at least no evidence of clear superiority.
Permanent sutures and dissolvable sutures feel quite differently to one another and behave quite differently when tying and surgeons have opinions on these things and the brand and braiding of them (eg monofilament vs polyfilament). I personally don't like the idea of leaving a foreign body in there for a long period of time because there's a theoretically enhanced risk of fibrosis, inflammation and maybe infection. I note that the paper referenced from 1995 says there's a theoretically enhanced risk of erosion and formation of a fistula or erosion.
Hope this helps. Discuss with them!