Sacral colpopexy, also known as sacrocolpopexy or sacrospinous colpopexy, is a surgical procedure used to correct pelvic organ prolapse in women.
When the muscles around a woman’s pelvis weaken, the pelvic organs can prolapse (slide out of place). This creates a bulge in the vagina. It most commonly occurs after menopause, childbirth, or a hysterectomy.
According to several studies, including this one from 2017, sacral colpopexy is one of the most effective and safe treatments for vaginal prolapse, with a very high long-term success rate.
While there are several surgical repair options for vaginal prolapse, abdominal sacral colpopexy is the most widely preferred method to correct it.
When done laparoscopically, it is a minimally invasive correction that offers almost all of the same benefits of a more invasive surgery, such as vaginal repair.
According to a 2011 study, all 94 women who had the laparoscopic procedure noted that the procedure had a significant impact in alleviating their uncomfortable symptoms and improving their sexual function and social life.
Because the vagina is close to the bladder and intestines, prolapse can affect how these organs work. According to the University College London Hospitals, after a sacral colpopexy and vaginal back wall operation (see “complementary procedures” below), 70 percent of women said they experienced less leakage and better control of their bowels.
However, it’s important to note that, while bladder and bowel symptoms could improve after the operation, it is not uncommon for them to remain unchanged or, in rare cases, worsen.
The recovery time for a sacral colpopexy is typically around six weeks. You should not plan to go to work or carry anything heavier than 10 pounds for at least this long.
If you work in a high-stress industry, you may need to consider taking off a little longer. Other best practices for recovery include:
- Taking laxatives. In order to keep your bowels clear, it’s recommended that you take laxatives every day for the first six weeks.
- Taking showers or baths. Gently wash around your vaginal opening by directing water to it and cleaning off any discharge or blood. You may use soap on the outside, but be careful not to get any on the inside of your vagina. If you prefer taking baths over showers, do not stay in longer than 10 minutes and bathe only in shallow water.
- In addition to your daily bath or shower, it is recommended that you gently wash around the vagina twice a day for the first two weeks out of the hospital.
- Using pads instead of tampons if you have your period.
- Avoiding sexual intercourse until after six weeks after the procedure.
Complications can occur if proper steps are not taken during recovery. Complications may include:
- bladder and bowel issues
- damage to other organs
- painful sexual intercourse
Some women who have sacral colpopexy experience nerve damage to the leg, pelvis, or buttock. This has been described as a “pins and needles” feeling or loss of sensation. Long-term nerve damage tends to be rare.
There are alternatives to abdominal surgical correction of pelvic organ prolapse. These include:
- vaginal pessary, a device that’s inserted in the vagina in order to prevent a prolapse from descending further
- pelvic floor exercises (e.g. Kegels), which should be done for a minimum of four months and tend to have more positive effects for women with smaller prolapse
- laparoscopic mesh sacrocolpopexy, which is a different type of vaginal surgery that uses a mesh implant to move and hold the vagina back into a more normal position
Urinary incontinence surgery complements many sacral colpopexy operations, as bladder or bowel issues tend to exist with a prolapse.
Because the vaginal vault (the expanded region of the vaginal canal at the internal end of the vagina) and back wall tend to prolapse around the same time, sacral colpopexy procedures are also commonly combined with vaginal back wall repair.
- heavy vaginal bleeding
- severe vaginal or abdominal pain
- high fever
- inability to urinate or a burning sensation when urinating
- swelling or redness in lower legs
- difficulty breathing
- inability to open your bowels for three days or more
There are a number of options for a woman experiencing pelvic organ prolapse.
Surgically, sacral colpopexy is regarded of as one of the most effective, and least invasive methods. Often performed laparoscopically, sacral colpopexy can result in smaller incisions and a shortened hospital stay.