Atrium Health Navicent Women's Care Urogynecology & Pelvic Surgery
Sacralcolpopexy
What is a sacrocolpopexy?
Sacrocolpopexy is a procedure used to correct prolapse of the vaginal vault or apex (top of the vagina). It involves attachment of synthetic or biologic graft from the vagina to the sacrum. While it can be performed alone, it is often performed with additional procedures to treat the other components of POP or incontinence procedures as these disorders can occur together.
How is the procedure performed?
Sacrocolpopexy is a procedure that is traditionally performed abdominally to correct pelvic organ prolapse, however minimally invasive approaches to sacrocolpopexy are offered by Dr. Kow that are performed laparoscopically or with robotic assistance. This provides the patient a quicker recovery for a procedure that is considered the gold standard for treatment pelvic organ prolapse.
The procedure is performed by dissecting the vagina away from the bladder and rectum. Afterwards a small piece of permanent mesh is used to attach the vagina to a ligament (anterior longitudinal ligament) that overlies the sacrum (tail bone). The peritoneum which is a the lining of the abdomen and pelvis is then used to cover up the mesh. If additional procedures are planned, they will then be performed.
What are the advantages of minimally invasive sacrocolpopexy?
Minimally invasive sacrocolpopexy provides similar results to abdominal sacrocolpopexy, while providing some additional benefits to you. These include the following:
- Decreased blood loss during surgery
- Decreased pain after surgery
- Faster return to normal activities
- Smaller incisions
It is important to ask your surgeon if they are trained to perform minimally invasive sacrocolpopexy since it often requires additional training to perform. Typically, performing this procedure requires additional training that is obtained through a fellowship in FPMRS, like Dr. Kow.
What should I expect?
After initial consultation with Dr. Kow, you may be asked to undergo some bladder testing (urodynamics) prior to surgery. Prior to surgery, you will need to attend a pre-operative visit with Dr. Kow and draw some basic lab work. Should you need surgical clearance, you will be asked to obtain this prior to surgery.
The surgical procedure takes approximately 1.5 to 2 hours to complete. It utilizes several small incisions in the abdomen to allow the surgeon to use laparoscopic instruments to complete the surgery. If the robotic approach is utilized, similar incisions are created to allow placement of instruments. You will be under general anesthesia during the procedure.
What is my recovery time?
Typical recovery time is one overnight stay at the hospital. While pain tolerance is variable among patients, most patients report minimal pain with laparoscopic or robotic sacral colpopexy. Overall recovery time includes six weeks with some activity restrictions, however patients are often able to return to a normal routine shortly after surgery. Restrictions including the following:
- No heavy lifting of more than 10 lbs for 6 weeks
- No tub baths for 6 weeks
- No sexual intercourse for 6 weeks
- No driving while on narcotic pain medications
What are the risks of the procedure?
Complications are typically very low with sacrocolpopexy (1-2%), especially when performed laparoscopically or robotically. However with every procedure there always some risks including anesthesia problems, postoperative pain, intraoperative bleeding, infection, blood clots and damage to adjacent organs. Risks that are specific to sacrocolpopexy include the following:
- 2-3% risk of bladder or ureteral injury
- 1-2% risk of mesh exposure
Will my insurance company cover the procedure?
Most insurance policies will cover sacrocolpopexy. Our office will help you with obtaining prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier to determine the details regarding your coverage.