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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.



  • 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

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Copyright 2019 Dr Jo Schoeman