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What to expect during a sacrospinous fixation (hysteropexy) procedure
Your uterus and vaginal vault (the expanded region of your vaginal canal at the internal end of your vagina) are normally held in place by various muscles, tissue, and ligaments in your pelvis. When they become too weak, your uterus or vaginal vault may shift from their typical positions, leading to problems with urination and bowel movements.
Private sacrospinous fixation (known as uterus repair or vault repair) involves placing a strong stitch around one of the ligaments connecting to your backbone, which helps to hold up your vagina and keep it in the correct position. The treatment should improve the function of your bladder and bowel, with complete recovery usually occurring around six to eight weeks after surgery.
If you would like some more information on sacrospinous fixation, or other treatments for pelvic and/or vaginal issues, our experienced consultants are here to help you. Call 0141 300 5009 or book online today and you could have your initial consultation within 48 hours.
This page provides you with a complete overview of what to expect from sacrospinous fixation, including its cost, causes, and how treatment works.
Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.
|Patient pathway||Initial consultation||Diagnostic Investigations||Main treatment||Post discharge care||Guide price|
|Hospital fees||N/A||Not included||£6,025||Included||£6,025|
|Consultants fees from||£200||N/A||Included||Included||£1,425|
Your consultant may recommend sacrospinous fixation when you have a uterus prolapse, which occurs when your pelvic floor muscles and ligaments become stretched and weakened to the point when they can no longer provide support for your uterus. This means that your uterus slips down into your vagina or protrudes out of your vagina. You are more likely to experience this issue after menopause or after giving birth (typically after one or more vaginal deliveries).
Sacrospinous fixation might also be needed if the top of your vagina (your vaginal vault) sags and falls into your vaginal canal, which can occur as a result of a hysterectomy, which is a procedure that involves the removal of your uterus.
It could be that you don't experience any symptoms as a result of either a uterus or vaginal vault prolapse, with no medical treatment being required.
However, other people will have significant symptoms that affect their quality of life, meaning they will want or need to seek treatment. These include:
No imaging tests are needed for determining whether you require sacrospinous fixation. If your consultant suspects you have problems with your bladder, they may take a urine test to check for any infections, or insert a small tube into your bladder to see if there are any other problems.
Please note that you can always ask for a female consultant and/or have a member of your support network with you during the consultation.
By strengthening the muscles around your bladder, buttocks, and vagina, pelvic floor exercises can prevent your prolapse symptoms from getting any worse. These exercises usually involve being sat down comfortably and squeezing your muscles 10 or 15 times. To start with, don't hold your breath or tighten your stomach. Over time, you'll be able to hold each squeeze for longer.
A vaginal pessary is a device that your consultant will insert into your vagina to hold your prolapsed womb and/or vaginal walls in place. You may receive a ring pessary, which is round and comes in different sizes, or a shelf pessary, which gives you extra support in cases where your ring pessary does not stay in place. Your consultant will take care to ensure you're given a vaginal pessary that is most suitable for you.
After your sacrospinous fixation, you'll need to stay in hospital for a couple of days so that we can monitor how you're doing. So, ahead of coming to hospital, think about bringing along anything that might make your time with us more comfortable, such as loose-fitting clothing or a laptop/tablet to keep you entertained.
Smoking increases your chances of breathing and heart troubles both during and after surgery, along with potentially affecting the quality of your recovery. If you smoke, your consultant may then recommend that you stop two weeks prior to your sacrospinous fixation.
For the first week after your sacrospinous fixation, you will need to take it easy and get plenty of rest, which means you won't be able to make trips to the shop on a daily basis. To make your recovery as smooth as possible, then, be sure to gather any supplies you might need before coming in for surgery. If you need anything else while you recover, ask a family member and/or friend to grab it for you.
Medications like aspirin, warfarin, or any anti-inflammatories (NSAIDs) can increase your chances of unwanted bleeding during and/or after surgery, so your consultant may speak to you about any medications before your procedure. It could be that you have to stop taking them for two weeks before your treatment.
Don't eat or drink anything after midnight on the day of your sacrospinous fixation, and avoid alcohol for 48 hours prior to your visit to hospital.
Sacrospinous fixation is usually done under general anaesthetic, which means you'll be asleep for the procedure and won't feel anything. If you prefer, your anaesthetist can administer spinal anaesthesia instead; you'll have no sensation below the waist and be awake for the procedure. They will speak to you beforehand about which anaesthesia option you would prefer.
Your sacrospinous fixation procedure will follow a series of steps, which include:
You will likely feel a bit groggy if you had your sacrospinous fixation under general anaesthetic, but this is completely normal. You'll be transferred to a private room and given some time to rest, receiving pain relief medication whenever necessary.
A catheter (a flexible tube used to collect urine) to your bladder will be attached, as this allows us to monitor your condition. Your nurse may also place a pack into your vagina to help with any bleeding and/or bruising, which is usually taken out 48 hours following your sacrospinous fixation.
To ensure your vaginal tissues heal properly and you make a full recovery, you'll need to take it easy and avoid any strenuous activities for the first few weeks. You may experience vaginal bleeding for up to two weeks, along with vaginal discharge for up to six weeks.
Take care to eat a healthy diet to avoid constipation, which could make your symptoms return, and avoid any heavy lifting.
After around three or four weeks, you should be able to return to work. When exactly you go back depends on how you've recovered, so please speak to your consultant about this. Your time away from work will be longer if you do any kind of manual labour. You can also start driving again at the four-week stage following your sacrospinous fixation.
Your consultant will recommend that you wait six weeks before having sex or doing anything physically strenuous, like heavy lifting.
As is the case with any surgery, some complications are possible, but these are very rare. Your consultant will talk to you about any risks involved before your sacrospinous fixation and answer any questions you might have about the procedure.
If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.
Content reviewed by Circle in-house team in December 2022. Next review due December 2025.