Sacral hysteropexy is an operation that suspends your uterus, using either a  graft of own native tissue (fascia lata), from the front of your sacrum (refer to the illustration below). This provides optimal support for your uterus and upper vagina. A repair inside your vagina may also be required at the same time. The operation can be performed in combination with other procedures. Dr Carey uses your own tissue (fascia lata) which avoids using synthetic mesh. Fascia lata is taken through a small incision from your thigh can be used instead of mesh (refer to the illustration below).. This operation is usually reserved for women with advanced prolapse of the uterus who wish to retain their uterus or when previous surgery to support the uterus has failed.

What happens during surgery?

The surgery is performed under general anaesthetic (you are completely asleep). The operation may require an incision on your abdomen or be performed by laparoscopy or using a robotic system (keyhole surgery). Dr Carey usually performs this operation by laparoscopy or robotically, but he will advise you which method is best for you. Your uterus is suspended with a  graft using your own tissue (fascia lata) from the front of your sacrum (tail bone). This provides very strong support for your uterus. A surgical repair of your vagina may be required, depending on the type of prolapse you have. At the end of the operation, a catheter is inserted into your bladder to drain urine. This will remain in place overnight. A cystoscopy (looking inside the bladder) will usually be performed at the end of the surgery to check that no damage has occurred to the bladder or ureters (the tubes running from the kidneys down to the bladder).

The illustration above demonstrates the uterus suspended from the sacrum by a graft from patient’s own tissue (fascia lata). A surgical vaginal support device (S-POP) is placed into the vagina at the end of end of surgery and is removed 21 to 28 days after surgery.

The illustration demonstrates that the fascia lata graft is taken from the thigh through a 3 to cm skin incision. 

Dr Carey will be happy to answer any questions you may have and can give more specific advice. Before deciding to have surgery, you should read carefully all the information about your operation and consider obtaining a second opinion.

If you experience complications after you leave hospital, contact Dr Carey or the nursing staff on 1 West at the Epworth Freemasons Hospital for advice. In an emergency you may attend the Royal Women’s Hospital, Parkville or Epworth Hospital, Richmond emergency department or attend your closest hospital emergency department.