Sacral hysteropexy is an operation that suspends the vagina or uterus, using a synthetic or biological graft, from the front of the sacrum (tail bone). This provides support for the uterus and upper part of the vagina. A repair inside the vagina may also be required at the same time. The operation can be performed in combination with other procedures. 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 (key-hole surgery). Dr Carey usually performs this operation by laparoscopy or robotically, but he will advise you which method is best for you. The uterus is suspended with a synthetic graft from the back of the sacrum (tail bone). This provides very strong support for the uterus. A surgical repair of the vagina may be required, depending on the type of prolapse you have. At the end of the operation, a catheter is inserted into the bladder to drain urine. This will remain in place over night. 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 synthetic graft. 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.
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.