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SACROCOLPOPEXY

Sacrocolpopexy is an operation which is performed to support the vagina in women with pelvic organ prolapse. In this condition, the roof of the vagina is collapsed and the organs in the pelvic region including vagina, uterus and bladder descend to a position which is lower from their original position.

Symptoms of pelvic organ prolapse include:

  • Pressure in the pelvic region
  • Vaginal bulge
  • Infection
  • Bleeding
  • Bowel movement problems
  • Need to manually assist in voiding or defecation
  • Back pain
  • Sexual dysfunction

Contraindications

Women with the below conditions are not suitable candidates for sacrocolpopexy:

  • Uncontrolled hyperglycemia
  • Anemia
  • Intake of anticoagulants
  • Severe heart or lung problems
  • Venous thromboembolism
  • Infections such as cystitis or vaginal infections
  • Sexually transmitted diseases
  • Pelvic inflammatory disease
  • Cancers of the vagina, cervix or uterus
  • Fistulas such as rectovaginal, vesicovaginal, or urethral fistulas
  • Pregnancy or a plan for pregnancy

Preparing for the surgery

Before undergoing the surgery inform the doctor if there are chances of pregnancy and about the drugs which are currently in use. Considering these, the doctor will decide whether the surgery is suitable for the patient.

Few days before the surgery:

  • Blood tests may be performed to check the need for blood transfusion
  • Some of the drugs currently in use need to be discontinued as per the doctor’s advice. These mainly include aspirin, clopidogrel, warfarin, naproxen, etc.
  • Smoking should be stopped to promote faster healing

One day before undergoing surgery

  • Do not eat or drink anything for a whole night and until the surgery
  • Take the important drugs as advised by the doctor with a sip of water

Procedure

The main aim of the surgery is to restore the positions of the pelvic organs and to relieve the symptoms. It may take around 1-2 hours to complete the surgery.

Before performing the operation, the surgeon gives anesthesia to cause numbness either at the surgical site or the entire body.

Laparoscopic sacrocolpopexy is performed by making small incisions in the abdominal region through which a video camera and the necessary surgical tools are inserted.

During this procedure, a soft synthetic mesh is used to support the pelvic organs. Initially, the mesh is positioned with strap-like arms that are woven through the pelvis. Later, the body tissue grows through the mesh to provide the necessary support. It is a minimally invasive method which helps in a faster recovery and leaves only minor scars on the skin.

The main advantages of laparoscopic sacrocolpopexy are decreased risk of post-surgical complications and reduced blood loss due to the size of the incision.

After the operation

  • The doctor will suggest the patient to mobilize on the same day to prevent certain complications such as blood clots
  • The patient may return to the daily activities in 2-3 weeks after the surgery
  • The urinary catheter will be retained for 1 or 2 days. Vaginal bandage used at the time of surgery may be removed the next day
  • Pain relieving medicines will be given to reduce pain in the abdomen or pelvis. These may be continued for few days to weeks after the surgery. Also, estrogen containing cream may be prescribed to help in vaginal healing
  • There can be a discomfort and numbness at the site of operation
  • Some of the other symptoms which may be present include a brown discharge from the vagina, wound pain, nausea, vomiting, and tiredness
  • Light foods such as drinks may be taken after the surgery while avoiding solids for few days as suggested by the doctor

Post-surgical care

The below measures can help in a faster recovery from the surgery:

  • Maintaining regular bowel movements while avoiding straining
  • Avoiding strenuous exercises or activities for nearly 6 weeks after the surgery
  • Avoiding sexual intercourse for about 6 weeks

Risks

Similar to any other surgical procedure, sacrocolpopexy is associated with certain risks which may include:

  • Infection of the surgical wound
  • Bleeding from the incision
  • Formation of blood clots which can move from legs to the lungs
  • Side effects of the anesthetics

Additionally, the following risks are involved which are specific to sacrocolpopexy:

  • Damage to the surrounding organs such as bladder, bowel and ureters of the kidneys
  • Difficulty with bowel movement and bladder function
  • Pain during the intercourse
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