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Sacrocolpopexy

Last updated on 27th March 2016

Laparoscopic sacrocolpopexy is an operation which involves supporting the vagina to the ligament on the spine (after previous surgery to remove the womb) by using a synthetic mesh. It is an effective treatment for women with vault prolapse, which is when the roof (or vault) of the vagina has collapsed in a woman who has already had a hysterectomy.

Prior to surgery, women complain of typical prolapse symptoms, which include a heaviness or dragging sensation inside the vagina. Many women can see or feel a lump protruding, and may have associated impairment in bowel, bladder and sexual function. The objective of the operation is to relieve your symptoms, and restore vaginal anatomy.

We are able to perform this operation through keyhole surgery (“laparoscopic sacrocolpopexy” – diagram or video), which offers the advantages of less scarring and a quicker recovery, than when the operation is performed through a larger abdominal incision.

What happens after the operation?

After the operation, you may experience nausea and wound pain. Medication will be given to relieve these symptoms. You will normally be allowed to drink on the same day of operation. The urinary catheter will be removed usually after one-two days. Some women will already have gone home and may return to have the catheter removed.  The nurse looking after you will make sure you are passing water without a problem and check there is not a large volume of urine left in the bladder after you have finished urinating.  A small number of women will inadequately empty their bladders. They will go home with a catheter in and come back a week later for removal of the catheter. If a vaginal pack / bandage is used at the time of surgery, it is removed the following day.

You are likely to be able to start a light diet after surgery. It is particularly important that you keep your bowel habit regular and avoid straining. We may prescribe a stool softener to facilitate this.  You are likely to experience pain in the abdomen / pelvis that will require regular painkillers for a few weeks following surgery. Your doctor may also prescribe some oestrogen cream to be used for a few weeks following surgery to aid vaginal healing.

Are there any risks?

Laparoscopic sacrocolpopexy is safe and very effective, but as with any surgical procedure there are risks attached. Some women have such dense scarring because of their previous surgery that preclude us from performing the procedure safely with keyhole surgery, and we may need to perform the prolapse repair via the vagina. This is rare. The risks common to all operations include anaesthetic risks, infection, bleeding, recurrence of symptoms  and formation of a blood clot in the legs/lungs.

The main risks specific to laparoscopic sacrocolpopexy are:

What should I do after the operation?

You should be back on your feet relatively quickly, but you avoid heavy lifting for 6 weeks. There may be some bleeding / brown vaginal discharge as the wounds in the vagina heal which is completely normal. Remember this is major surgery, and you may require regular painkillers for a few weeks following surgery.

Sexual intercourse may be resumed after 6 weeks if you are feeling comfortable and the discharge has stopped. We generally suggest 6  weeks off work.

Images

Sacrocolpopexy diagram Sacrocolpopexy

Videos

Sacrocolpopexy
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