Sacrospinous ligament suspension is a procedure used to correct vaginal prolapse (when the top of the vagina slides down into the vaginal canal, usually causing a bulge). It often is performed at the same time as a hysterectomy but can be done years later. Occasionally it is done with the uterus still in place.
The sacrospinous ligament is a tough band of tissue that connects your pelvis to your lower back and tailbone. Because of where it’s located, it provides a good point of support for the top of the vagina.
Sacrospinous ligament suspension is typically performed through the vagina, and the surgeon does not go through the pelvic cavity, making it safer than some of the other prolapse procedures.
During surgery, the surgeon finds the sacrospinous ligament and removes any overlying tissue. Next, your surgeon will use sutures (stitches) to sew the top part of the vagina to the ligament, to restore support. Additional prolapse procedures, such as an anterior colporrhaphy or posterior colporrhaphy, can be done at the same time to correct any additional prolapse of the vaginal walls.
You may be asked to undergo some bladder testing called urodynamic testing. You’ll need to attend a preoperative visit where you will talk with your provider about what to expect and undergo some basic lab work. If you need surgical clearance or prior authorization, you will be asked to get this before to surgery.
Sacrospinous ligament suspension takes about 1 to 2 hours when done with additional procedures, and you will be under general anesthesia. You will stay in the hospital overnight.
Most patients report minimal pain with sacrospinous ligament fixation. You can expect some activity restrictions for about 6 weeks, but many patients can return to a normal routine shortly after surgery. Activity restrictions include:
The risk of complications from a sacrospinous ligament fixation is typically very low. As with any procedure, there is a risk of anesthesia problems, pain, bleeding, infection, blood clots or damage to nearby organs, but these are rare. Risks specific to this procedure include:
Check your insurance plan benefits to see if your policy covers a sacrospinous ligament suspension. If it does, our office will help you get prior authorization if your insurance policy requires it. If you have further questions, contact your insurance carrier.