Sacrocolpopexy is basically a procedure to treat vaginal vault prolapse (top of the vagina) in women who have had their uterus removed. The operation’s main purpose is to re-establish the vagina in its ordinary position and function. There is another surgery of this type called sacrohysteropexy which corrects even uterus prolapse.
What do we know about vaginal prolapse ?
The organs inside a woman’s pelvis (these include the uterus, the vagina, the bladder and the rectum) are normally secured in their place by ligaments and muscles otherwise known as the pelvic floor. If these supportive structures are damaged by overstretching, the pelvic organs can bulge (or prolapse) from their natural position down into the vagina. When this occurs it is known as pelvic organ prolapse. Sometimes a prolapse can be significant enough to protrude outside the vagina.
What are the types of vaginal prolapse ?
These are of three basic types.
- Anterior vaginal prolapse : It is the anterior vaginal wall that supports and holds the bladder. If the vagina moves out of place, the bladder also moves. This kind of prolapse is known as a cystocele. This anterior vaginal wall prolapse greatly affects function of the bladder. Urinary symptoms include difficulty in urinating, incomplete emptying of bladder, overactive or hyper bladder symptoms like urine leak whilst coughing, sneezing, laughing hard, or even exercising.
- Posterior vaginal prolapse : The posterior vaginal wall supports and holds the rectum (where the stool is stored daily). When the posterior vaginal wall weakens, the rectum can prolapsed. This prolapse is the rectocele.
Posterior vaginal wall prolapse make stool and bowel movements pretty difficult, since forcing the stool down makes the rectum swell forward, rather than pushing out the stool. - Uterine Prolapse : The third type of prolapse is when the uterus hangs down, into the vagina. Finally the uterus can protrude outside the body. This is called a third-degree prolapse.
What are the clinical features of vaginal prolapse ?
Mild prolapse often causes no symptoms and treatment is also not always necessary. But, prolapse definitely can affect the quality of life by causing discomfort or heaviness. Bladder trouble, bowel problems and sexual activity may also be affected.
How is vaginal prolapse diagnosed ?
- A complete physical examination of the body is mandatory.
- A prolapse is easily diagnosed with a vaginal examination. Your gynaecologist will put a speculum (that is a plastic or metal instrument, to split the vaginal walls and see cervix and vagina) to note which organ or organs are prolapsing.
- A pelvic ultrasonography may also have to be performed to study the pelvis.
How does sacrocolpopexy procedure work ?
Sacrocolpopexy corrects the position of the vagina and the pelvic organs and hold them in that place is an additional way to correct prolapse. Your doctor will educate you on risks and benefits. Prior to surgery, food and fluid are to be avoided for 6 hours atleast. Sacrocolpopexy is done either with an abdominal cut or laproscopically, through ‘keyholes’, under general anaesthesia. The vagina first has to be separated from the bladder in the front and the rectum at the backside. A graft consisting of a permanent synthetic type of mesh is used to support and enclose the vagina. The mesh is then bound to the sacrum (tail bone) to give it an attachment and covered up by a tissue layer to prevent the bowels from getting stuck to it. Sacrocolpopexy can also be done at the same time as surgery for urinary incontinence or for bladder or bowel prolapse.
How successful is sacrocolpopexy procedure ?
A majority of women getting treated by sacrocolpopexy are cured of both their prolapse and their symptoms.
However, after surgery there is a minute risk of prolapse developing in an additional part of the vagina, such as the front wall that supports the bladder. If this develops it may need further surgery.
What could be the complications of a sacrocolpopexy procedure ?
The complications are rare for both the open and laparoscopic kind of techniques, but they may include the following in a small percentage of patients.
- Pain (during intercourse)
- Exposure of the vaginal mesh
- Damage to either the bladder, bowels or ureters.
The other risks associated with surgery also include wound and urinary tract infection, excessive bleeding, deep vein thrombosis (commonly known as clots) in the legs, as well as chest infection and heart problems.
What is the care to be taken after the sacrocolpopexy procedure ?
Your hospital stay can vary anything between 2-5 days. During the first 6 weeks you should totally avoid activities like heavy lifting. Gentle walking is a good exercise to start with. Swimming, fitness exercises and intercourse are best avoided for 6 weeks post surgery. Various lifestyle interventions including stopping smoking, weight loss, gentle exercise and preventing constipation will have to be ensured.
How to find gynecologists for sacrocolpopexy procedure ?
Now you can find gynecologists for sacrocolpopexy procedure from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple gynecologists, get approximate cost of sacrocolpopexy procedure from different hospitals, compare things and then choose a gynecologist for sacrocolpopexy procedure .
Find and choose a gynecologist for sacrocolpopexy procedure on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
