Atrium Health Navicent Women's Care Urogynecology & Pelvic Surgery

Uterosacral ligament suspension

What is a uterosacral ligament suspension?

Young woman standing with her arms crossed, smilingThe uterosacral ligament suspension is a procedure used to correct prolapse of the vaginal vault or apex (top of the vagina). It is typically performed at the time of vaginal hysterectomy, although it can also be performed in other situations.

The uterosacral ligaments are support structures that typically keep the cervix and uterus in the pelvis. As those ligaments weaken and stretch, women can develop prolapse. The goal of the uterosacral ligament suspension is to resuspend the vagina or cervix/uterus (in the case of a uterine sparing procedure) to a portion of the uterosacral ligament that is higher up in the pelvis.

How is the procedure performed?

Uterosacral ligament suspension is typically performed as a vaginal procedure, however occasionally it is performed abdominally or laparoscopically. When performed at the time of hysterectomy, the uterosacral ligaments are identified after the uterus and cervix are removed. Afterwards, sutures are used to attach the vaginal cuff to the uterosacral ligaments, which are ligaments that are higher up in the pelvis. Often times, additional prolapse procedures such as an anterior colporrhaphy and posterior colporrhaphy are performed to correct any additional prolapse of the vaginal walls.

Young woman standing with her arms crossed, smilingWhat 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 preoperative 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 to 1.5 hour to perform when performed with a vaginal hysterectomy as well as any additional procedures to correct a cystocele or rectocele. 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 uterosacral ligament suspension. 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 from a uterosacral ligament suspension are typically very low. However with every procedure there always some risks including anesthesia problems, postoperative pain, intraoperative bleeding, infection, blood clots and damage to adjacent organs. With regards to the uterosacral ligament suspension, some specific risks include the following:

  • 1-10% risk of ureteral kinking/obstruction
  • 5-10% risk of postoperative urinary tract infection

Will my insurance company cover the procedure?

Most insurance policies will cover uterosacral ligament suspension. 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.