What Is Sacrocolpopexy?

Sacrocolpopexyis an operation performed from the abdomen to support the vagina to the ligament on the spine (after previous or present surgery to remove the uterus) by using a synthetic mesh.

Why Is Sacrocolpopexy Performed?

Sacrocolpopexy is performed to treat severe protrusion or bulge(s) of the vagina after removal of the uterus. A woman’s vagina that has one or more of these vaginal protrusion(s) may experience one or more of the following:

1. The vaginal lump/bulge or protrusion feels uncomfortable or causes pain.

2. Difficulty with urination (e.g. unable to completely empty the bladder)

3. Bowel difficulties (e.g. constipation, incomplete emptying of bowels)

4. Pain

5. Infection

6. Bleeding

The objective of the Sacrocolpopexy operation is to relieve the woman’s symptoms and to restore her vagina and her vaginal anatomy (as much as possible) and recover her sexual function.

Are there any risks associated with Sacrocolpopexy surgery?

Sacrocolpopexy surgery is a very common and relatively safe operation with excellent prognosis and outcomes. However, like any surgical procedure, there are complications which may occur. Possible complications from Sacrocolpopexy surgery may include:

1. Bleeding

2. Infection

3. Injury to surrounding tissues (e.g. nerve or blood vessels, urethra, intestines)

4. Formation of blood clot(s) in the legs or lungs

5. Recurrence of problem

6. Slow return of bowel or bladder function

7. Erosion of synthetic material through vaginal mucosa

What Happens Before Sacrocolpopexy Surgery?

1. Blood tests, electrocardiography (ECG) and chest X-ray may be done to ensure that you are in optimal health for Sacrocolpopexy surgery.

2. Your doctor may prescribe oral or vaginal estrogen (hormone) if you are already menopausal. It is important to comply with this medication as it ensures that your vaginal tissues are optimal for surgery and healing.

3. You will be admitted to the hospital one day before Sacrocolpopexy surgery.

4. You will be given preparations to clear your bowels.

5. Your pubic area will be shaved.

6. You will not be allowed to eat or drink after midnight on the day before the surgery.

7. All your medical and surgical conditions, if any, must be made known to the doctor and must be optimally controlled.

8. If you are on aspirin, please keep your doctor informed. You must stop taking aspirin at least one week before Sacrocolpopexy surgery.

What happens during the Sacrocolpopexy surgery?

The surgery is done under general or regional anesthesia. The anesthesiologist will discuss with you the advantages and disadvantages of both methods. An abdominal incision is made. The synthetic mesh is stitched to the posterior surface of the vagina and to the ligaments in front of the spine. A tube / drain may be inserted into the abdomen to monitor the bleeding. Another tube will be inserted into the urethra as there may be difficulty in urination after the Sacrocolpopexy procedure. Painkillers, laxatives and antibiotics would generally be prescribed after the procedure.

What happens after Sacrocolpopexy surgery?

Immediately after the operation, you may experience one or more of the following:

1. Tiredness – You should rest and gradually increase your mobilization until you feel fit to return to your normal activities.

2. Discomfort – In the lower part of the abdomen, over the incision. This is to be expected and painkillers should help to relieve the discomfort.

3. Vaginal bleeding – Mild to moderate amount of reddish watery discharge after surgery is quite normal. You will need to wear a menstrual pad during the recovery period, but you will not be permitted to use tampons for obvious reasons.

One day after surgery, you will usually be allowed to drink and eat. You will be encouraged to move around. Blood chemistries and normal follow-up visits will be performed. The catheter that was placed in your urethra is usually removed the day after surgery. The drain is usually removed two days after the operation.

You may be discharged on the third or fourth day after surgery if the doctor is pleased with your progress and the outcome of the Sacrocolpopexy procedure.

You should refrain from:

1. Strenuous exercise for 2 months. You may return to normal activity after that or upon clearance by your doctor.

2. Using tampons, douching, and sexual intercourse and driving for 4 weeks.

3. Carrying heavy weights (> 10 pounds) for 6-8 weeks after Sacrocolpopexy surgery.

You should (immediately) return to the hospital or notify your doctor if you notice any of the following:

1. Heavy vaginal bleeding

2. Foul smelling vaginal discharge

3. Severe abdominal distension and / or pain not relieved by painkillers

4. High fever

5. Pain associated with passing urine

6. Difficulty in passing urine

7. Constipation

Follow-up doctor visits after Sacrocolpopexy surgery. You will be examined by your doctor (at your doctor’s office) at approximately;2 weeks, 4 weeks, six months and one year after Sacrocolpopexy surgery. It is important to keep your follow-up appointments to ensure the best possible results.