It is well established that transient voiding dysfunction is a common complication of anterior vaginal wall repair for pelvic organ prolapse surgeries. We looked for all possible factors that increase the risk of voiding dysfunction of anterior vaginal wall repair studied in the literature. 
These factors were either, patient’s factors, or intraoperative factors. Among the patient factors the age, BMI, past medical and Surgical history, Smoking, coexisting overactive bladder, preoperative urinary retention, preoperative and post operative urinary tract infections. The intraoperative factors include the type of anesthesia used, duration of surgery, intraoperative blood loss, bladder injury, concomitant suspension or hysterectomy & the use of mid-urethral sling. Those factors have been studied extensively and reported in the literature. 
We hypothesized that the type of suture material used in anterior vaginal wall repair may create a difference in postoperative voiding dysfunction. This factor was never studies in the literature. We compared anterior plication using monofilament (Polydioxanone and Polyglycolide–trimethylene carbosnate ) suture to multifilament Polyglactin suture in terms of postoperative voiding dysfunction.

This was a retrospective cohort chart review study of all patients underwent anterior vaginal repair surgery in the past 5 years between 2019 and 2023 in our tertiary hospital, urogynecology department. A total of 163 patients were included. No patient was excluded. Data collected from hospital system. All operative room schedules revised, all anterior vaginal wall repair cases under urogynecology department were collected and their file was reviewed in detail. Looking for all factors mentioned above that may affect voiding dysfunction post operatively including our research question which is suture material. Then voiding trial studied in detail. Voiding Dysfunction Defined as We use a Post void resideual of more than one third of total volume or postvoid residual volume of >150 mL documented by catheterization on at least 2 occasions within the first 48 hours of surgery. Data collected in excel file in confidential way. Then data was processed with SPSS system Then all variables were using multivariant regression analysis There is no conflict of interest. No funding. No harm.

We had 68 patients in polyglactin group and 95 patients in Polydioxanone and Polyglycolide–trimethylene carbosnate group. Here is the descriptive analysis of the two groups: First patient related: age P 0.569, BMI P 0.665, Parity P 0.176, Past Medical History P 0.218, Past Surgical history P 0.721, Smoking P0.141, Coexist Overactive bladder P 0.553, Pre-operative urine retention P 0.417, Pre-Operative urinary tract infection P 0.417. Surgical related: Anesthesia type P 0.529, Duration of surgery P 0.671, Estimated intraoperative blood loss P 0.203, Concomitant surgery divided into three subgroups first, anterior and posterior repair only P 0.985. second group: presence of slings: P 0.893. third group associateion with hysterectomy or suspension of anytype P0.96. Post Operative urinary tract infetion P 0.584. bladder injury intraoperatively P 0.571. Most importantly, voiding dysfunction between the two groups P 0.589

All factors mentioned previously were studies and there were no difference in the pupulation between our two groups in terms of these variables so that it has no effect on the voiding dysfunction studied and then as the two groups description is similar, results show the effect of suture material alone on voiding dysfunction concluding that no difference in voiding dysfunction between the two groups

Suture materials used in pubocervical fascia plication in anterior vaginal wall repair cases has no rule in post operative voiding dysfunction