Pelvic organ prolapse occurs when the muscles and connective tissues supporting the pelvic organs weaken or stretch. This allows the bladder, uterus or rectum to shift out of position and bulge into the vagina. It is common among women who have gone through childbirth, menopause or a hysterectomy.

Sacrocolpopexy is a surgical procedure designed to correct this problem. During sacrocolpopexy surgery, your provider lifts the organs back into place and secures them with surgical mesh. The mesh is anchored to the sacrum, a bone at the base of the spine. The mesh adds support that weakened ligaments can no longer provide.

Baptist Health offers the sacrocolpopexy procedure using robotic surgery. This allows for smaller incisions, greater precision, and often a faster return to daily life. If prolapse is affecting your quality of life, our women's care team can help you decide whether sacrocolpopexy is right for you.

Why Is Sacrocolpopexy Performed?

Sacrocolpopexy surgery treats prolapse when the upper portion of the vagina shifts from its normal position. This is especially common after a hysterectomy. Removing the uterus reduces support for the top of the vagina.

Your provider may recommend the sacrocolpopexy procedure if you experience symptoms such as:

• A noticeable bulge or pressure in the vagina.
• Difficulty emptying your bladder or bowels.
• Urinary leakage during physical activity.
• Discomfort or pain during intercourse.
• A feeling of heaviness or pulling in the pelvis.

Before recommending surgery, your Baptist Health provider will typically suggest other options first. These may include pelvic floor exercises, lifestyle changes or a vaginal pessary, a small device placed inside the vagina to support the impacted organs. If these approaches do not relieve your symptoms, sacrocolpopexy may be the next step.

Who Is a Candidate for Sacrocolpopexy?

The sacrocolpopexy procedure is most often considered for women with moderate to severe prolapse who have not found relief through nonsurgical treatments. Your provider may recommend this surgery if you:

• Have vaginal prolapse following a hysterectomy.
• Have prolapse that has returned after a previous repair.
• Are in overall good health and able to tolerate general anesthesia.
• Do not plan to become pregnant in the future.

Sacrocolpopexy is not recommended for women who wish to have children. A future pregnancy could reduce the effectiveness of the repair. Your provider will review your medical history to determine whether this procedure is the best fit.

What Happens During Sacrocolpopexy Surgery?

Sacrocolpopexy is performed under general anesthesia. A robotic sacrocolpopexy approach involves several small incisions in the lower abdomen. A tiny camera and specialized instruments are inserted through these openings. Your provider guides the robotic arms using a console.

During the procedure, your provider separates the vaginal wall from the bladder in front and the rectum in back. Lightweight surgical mesh is then attached to the front and back surfaces of the vagina. The other end is secured to the sacrum at the base of the spine, restoring the vagina to its normal position and providing lasting support.

The mesh is then covered with a layer of tissue called the peritoneum to avoid contact with the bowel. If needed, your provider may perform additional repairs for prolapse in other areas. A hysterectomy can also be performed at the same time if appropriate.

Robotic sacrocolpopexy offers several advantages over open surgery, including less blood loss, reduced scarring and a shorter hospital stay. The robotic instruments allow for precise movements that would be more difficult for human hands in the tight spaces of the pelvis. The procedure typically takes two to four hours.

Recovery After Sacrocolpopexy

Sacrocolpopexy is often an outpatient procedure, so many patients go home the same day. In some cases, your provider may ask you to stay overnight. Before discharge, your care team will want to make sure you can empty your bladder on your own.

Some abdominal soreness, bloating and fatigue are normal in the first few days. Most women feel noticeably better within a week. Full recovery typically takes six to eight weeks. During this time, avoid lifting over 10 pounds. Also, skip strenuous exercise and refrain from sexual activity.

Your Baptist Health provider will schedule follow up appointments to monitor healing and address any concerns.

Risks and Considerations

Sacrocolpopexy is considered safe with high rates of long term success. Like any surgery, however, it carries some risks.

Possible risks include:

• Injury to the bladder or bowel.
• Bleeding or blood clots.
• Infection at the incision site.
• Difficulty with urination or bowel movements.
• Pain during intercourse.
• Recurrence of prolapse.

Your provider will discuss the risks and benefits with you so that you can make an informed choice.

Long Term Outlook

Most women experience significant relief from prolapse symptoms after sacrocolpopexy. The procedure restores pelvic support and can improve bladder and bowel function.

To protect your results over the long term, your provider may recommend that you:

• Maintain a healthy weight.
• Avoid heavy lifting whenever possible.
• Treat chronic constipation or cough quickly.
• Practice pelvic floor exercises.

Prolapse can return in rare cases. If symptoms come back after surgery, contact your Baptist Health provider. Additional treatment options may be available.