Sacrohysteropexy

Who is eligible for sacrohysteropexy?

If you have had symptoms of prolapse for a time that are reducing your quality of life, then you could be a candidate for this operation.

Surgery may be an option when there is no improvement in symptoms:

• you have tried pelvic floor exercises
• lost weight (if you were overweight)
• you have given up smoking to stop your cough
• vaginal pessaries haven’t helped or are unsuitable
• your symptoms are considerable affecting your whole approach to life
• you wish to maintain fertility or just prefer not to have a hysterectomy

What’s involved?

Mr Broome will make three 1cm incisions through which the telescope and instruments are passed. One is positioned in your belly button (where the camera is inserted), in the middle of your bikini line and one on the left of your tummy. The mesh is inserted via the bikini line incision and sutured to the back of the cervix, the womb is lifted up and the other end of the mesh is tacked to the sacrum (tailbone). The mesh is also covered with a thin layer of tissue to prevent adhesions, mesh erosion or scar tissue formation. Hospital stay is usually overnight and return to normal activity can resume after 2-3 weeks depending on the individual.

The use of mesh for prolapse repair, is it safe?

Mr Broome would like to reassure all his patients who have undergone or are due to have a sacrohysteropexy operation for utero-vaginal prolapse that there is absolutely no risk of vaginal mesh erosion following this procedure.

Unlike vaginal mesh implants a sacrohysteropexy prolapse repair is an abdominal procedure (usually keyhole) whereby mesh is used as a sling to support the womb permanently. There are no vaginal incisions and the sling is attached between the cervix and sacral bone at the back of the pelvis. The mesh will never erode through these attachments and will never come into contact with the vagina.

Having undertaken over 3000 sacrohysteropexy procedures since 1998 Mr Broome has had no cases of vaginal mesh erosion and he is confident that this will remain the case in the future due to the very different anatomical approach used when compared to vaginal mesh implants.

Mr Broome does not perform vaginal mesh implants, and is completely confident in the safety of Sacrohysteropexy which continues to be approved by NICE

Prolapse of the uterus (womb)

• Patient decision aid about choice of procedure for prolapse of the uterus (NICE)
• Sacrohysteropexy for Uterine Prolapse (Womb Prolapse)
• Link to daily mail article

Here is a video of the Sacrohysteropexy operation performed laparoscopically (keyhole surgery) by Mr Broome.