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A sacrocolpopexy is a surgical procedure to treat recurrent pelvic organ prolapse of the upper vaginal vault. During the procedure your surgeon uses surgical mesh to lift your pelvic organs back into place.
What is sacrocolpopexy?
A sacrocolpopexy (also called sacral colpopexy) is a reconstructive surgical procedure to treat pelvic organ prolapse. Pelvic organ prolapse is when one or more of your pelvic organs (womb, cervix, bladder, urethra, intestines and rectum) slips down into your vagina due to a weakening of the muscles and tissues that support your pelvic organs.
During sacrocolpopexy, your surgeon puts the prolapsed organs back into place and secures them there by attaching a polypropylene mesh to the upper vagina and the sacral promontory. Sacrocolpopexy is usually used where a patient has recurrent prolapse of the upper vagina (vault).
Your procedure may be carried out using an open, keyhole (laparoscopic) or robotic assisted approach.
- An open abdominal sacrocolpopexy involves an incision (cut) about 8cm long near your bikini line.
- Keyhole uses a traditional ‘‘stick’ laparoscopic approach - a minimally invasive procedure using smaller “keyhole” incisions through which a tiny camera and surgical instruments are inserted. Laparoscopic surgery usually leads to a faster recovery.
- Robotic laparoscopy is when robotics are used to assist with the keyhole surgery. This approach can mean that your stay in hospital after your operation is shorter your recovery is quicker.
Your pelvic organs are kept in place by your pelvic floor muscles together with ligaments from your vagina to your backbone. If this support structure stretches, weakens or tears, your pelvic organs may slip out of position and hang down into your vagina. Your doctor may recommend Sacrocolpopexy as a treatment option to put, and keep, them back in place.
You may also need a sacrocolpopexy if you have had a hysterectomy, as this can sometimes reduce the normal support for your vagina. It is not recommended for anyone who wishes to have children in the future.
You can find more information on the types of pelvic organ prolapse on our website.
Whilst no surgery is without risk, serious complications with this type of surgery are rare. The main potential complications are:
- 10% failure rate resulting in recurrent prolapse
- 5% risk of urinary urgency or urge incontinence
- 1-5% risk of urinary tract or wound infection
There are also individual risks with a general anaesthetic which your anaesthetist will explain to you before the procedure.
- Stopping smoking several weeks before a surgery reduces your chances of complications such as infection, blood clots and poor healing and improves your overall health.
- You may need to stop taking blood thinning medication such as Aspirin, Plavix (clopidogrel), warfarin (coumadin) or Xarelto (rivaroxaban) – please inform your consultant if you are taking any of these.
- Try to maintain a healthy weight.
- Optimise your blood sugars if you are diabetic.
You will be given a general anaesthesia before the procedure.
During the operation you will be given antibiotics intravenously to reduce the chance of infection. Five small incisions are made in your stomach (each approximately 1cm in length). Your stomach is then inflated with gas to make space for the surgery. Your bladder and rectum are separated from your vagina and a permanent mesh is then attached to the top and bottom walls of your vagina, and to the ligament covering your upper tailbone (sacrum). The upper tailbone is higher than your vagina and enabling the mesh to support your pelvic organs. Before closing up your incisions with dissolvable stitches, your surgeon examines your bladder to ensure that it wasn’t damaged during surgery. A catheter will drain your bladder overnight.
You will usually be kept in hospital for 1 night following surgery. Your recovery will be monitored, and you will be allowed to drink and eat. The day after surgery, the bandage and catheter will be removed, and you will be encouraged to walk around.
You will have a small discharge/bleeding from your vagina for a few days. If the bleeding persists or gets heavier you should let your doctor know. If the bleeding recurs but is light contact your GP, however if it is heavy please contact the hospital.
Your consultant will advise you when to attend for a check-up in the weeks following surgery and, if you are fully recovered, you will be able to resume your normal activities.
Recovery from surgery usually takes between six and eight weeks. Make sure you keep your incisions clean and dry. Your consultant will advise you on how to care for them until they heal.
- You may have gas pains and swelling for up to 72 hours due to the gas used to inflate your stomach. A warm shower, heating pad and/or walking may help with gas pain.
- Get plenty of rest. Make sure you have an adult with you for the first one or two nights after surgery.
- Avoid fatty foods, which can cause nausea. Expand your diet gradually.
- Walk around your house to prevent blood clots from developing.
- Use stairs slowly and use the banisters for additional support, especially the first few days after surgery.
- Avoid heavy lifting, straining when passing a bowel motion, and constipation after surgery as these may increase your risk of recurrent prolapse.
- Avoid using tampons and having intercourse during the first six weeks after your surgery.
Contact your doctor if you have any of the following:
- Fever over 38 degrees Celsius or chills
- Red and swollen incisions or incisions that are leaking a bad-smelling discharge
- Heavy vaginal bleeding and are soaking more than one pad an hour
- A bad-smelling vaginal discharge
- Bad pain that doesn’t improve with pain medication
- Pain and swelling in your legs
- Bad-smelling or cloudy urine
- Pain when you pee
- Nausea or are vomiting
- You cannot pass urine for several hours or can only pass small amounts at a time