A mesh sacrocolpopexy is surgical procedure to help correct a prolapse of the vaginal vault using a synthetic mesh. It can be done abdominally or laparoscopically.
What is a Laparoscopic Mesh Sacrocolpopexy?
This is a keyhole procedure (laparoscopy) to correct a prolapse of the vaginal vault which can sometimes happen following a hysterectomy.
The vault is the top most part of the vagina previosly attached to the cervix and uterus. When this support is lost following a hysterectomy, the vault can slip down into the vagina. This occurs is 35-40% of women a few years after a hysterectomy. The prolapse can be severe enough to protrude outside the vaginal opening. It may also involve a prolapse of the front and back walls of the vagina.
What happens during the operation?
- the procedure is done under general anaesthetic and will require 1-3 days in hospital
- telescopes are placed into the abdominal wall and gas is introduced into the abdomen
- the bowel will be moved aside to expose the lower backbone (the sacrum). Important structures like the ureter (the tube that brings urine from the kidneys to the bladder) is visualised and moved aside
- a piece of Y - shaped mesh material is introduced into the abdomen and stitched to the top, back and front of the vagina inside the abdomen. The other end of the mesh is then secured to the seat bone or sacrum using either stitches or tacking pins. These do not have to be removed.
- the operation is designed so that the top of the vaginal vault is now 'suspended' to the seat bone inside the abdomen
- the mesh is buried under a protective covering called the peritoneum and eventually new tissue grows into the mesh.
- the mesh remains permanently in the body
Although the procedure has less mesh-related complication issues, there are still possible issues that may arise from the surgery
- wound infection from telescope placement
- bleeding from vessels within the abdomen
- urinary tract infection
- trauma to the ureter
- vaginal mesh extrusion - when part of the mesh may be exposed via the vagina. Vaginal oestrogen is usually prescribed for 10-14 days
- vaginal pain and painful intercourse. This may affect 1% of patients and is due to scar formation at the top of the vagina. It generally improves with time
- erosion of mesh into the bowel or bladder - although very rare, this may sometime occur and will need an operation to correct this
- infection in the mesh materiall
- laparotomy - opening up the abdomen to correct a complication
- gas related abdominal discomfort - resolves within 24-28 hours
- deep vein thrombosis due to prolonged immobility
Recovering from a Laparoscopic Mesh Sacrocolpopexy
- tiredness is common so it's important to rest at home
- gentle excercise around the home is encouraged to prevent a clot or DVT
- avoid strenouos excercise, heavy lifting and straining
- avoid constipation.
- you may start driving after 3-4 weeks as soon as you can press the emergency brake without it hurting
Our nurse will call you within a week after your opertion to ensure you are recovering well. At your post op exam after 6 weeks, an internal check will be done to check your prolapse correction.
If you experience any prolonged pain with no improvement after simple pain killers, have any heavy bleeding or if you feel unwell, please call our Rooms. Alternatively, you may call your GP or the Emergency Department at LGH if it is over the weekend.