Item Number:
Prolapse of the Vault of the Vagina
Why is it done?
- The aim of surgery is to relieve the symptoms of a vaginal bulge and/or laxity
 - Improve bladder function without interfering with sexual function
 - Used where own natural tissue is too weak to use
 - Vaginal prolapse is a common condition causing symptoms such as a sensation of dragging or fullness in the vagina, and difficulty emptying the bowel or bladder and back ache.
 - About 1 in 10 women need surgery for prolapse of the uterus or vagina.
 
How is it done?
- This procedure is done under a general anaesthetic.
 - Sacrocolpopexy is performed either through an abdominal incision or ‘keyholes’ (using a laparoscope or Robotic-assisted)
 - The vagina is first freed from the bladder at the front and the rectum at the back.
 - A graft made of permanent synthetic mesh is used to cover the front and the back surfaces of the vagina.
 - The mesh is then attached to the sacrum (tail bone)
 - The mesh is then covered by a layer of peritoneum that lines the abdominal cavity; this prevents the bowel from getting stuck to the mesh.
 - Sacrocolpopexy can be performed at the same time as surgery for incontinence or vaginal repair for bladder or bowel prolapse.
 - A pelvic drain is left post-operatively
 - A cystoscopy may be performed to confirm that the appearance inside the bladder is normal and that no injury to the bladder or ureters has occurred during surgery.
 - A pack may be placed into the vagina and a catheter into the bladder at the end of surgery.
 - If so, this is usually removed after 3-48 hours. The pack acts as a compression bandage to reduce vaginal bleeding and bruising after surgery.
 
Complications
- Pain (generally or during intercourse) in 2-3%
 - Exposure of the mesh in the vagina in 2-3%
 - Damage to bladder, bowel or ureters in 1-2%
 - There are also general risks associated with surgery:
 
– Wound infection,
– Urinary tract infection,
– Bleeding requiring a blood transfusion and
– Deep vein thrombosis (clots) in the legs,
– Chest infection
Copyright 2019 Dr Jo Schoeman