Sacrospinous Fixation / Ileococcygeus Suspension

A sacrospinous fixation is carried out to help repair the uterus or vaginal vault, restoring the its normal supportive function.

This surgery involves making an incision in the vagina and then placing stitching into a strong ligament (known as the sacrospinous ligament) in the pelvis, towards the cervix or vaginal vault. The stitching used is either permanent, or absorbed into the body gradually. What is left behind is the scar tissue, which acts as a supportive layer for the vagina or the uterus to correct the prolapse.

The sacrospinous fixation procedure is often carried out in combination with other procedures for the treatment of prolapse, such as a vaginal hysterectomy, or the treatment of bowel, bladder or stress urinary incontinence.

Preparing for surgery

Your doctor will go over the surgery with you in detail, whilst examining your overall health. You may be required to undertake certain tests, such as scans, x-rays or blood tests. You might also be asked to stop taking certain medications, such as aspirin, which can cause excessive bleeding.

Post-surgical advice

You will wake up in hospital with a drip attached and, in some patients, a catheter to the bladder. A pack into the vagina might also be present in order to help supress excessive bleeding and bruising. These will all be taken out within 48 hours.

A creamy white discharge is normal for up to 6 weeks as the stitches are beginning to absorb into the body. If you notice an unusually strong, bad smell from the discharge, you should seek medical advice right away. It is also normal to have some blood from the vagina for around a week after the surgery.

You should avoid strenuous activities for the first few weeks, but should be ok to drive and take short walks after four weeks. Avoid heavy lifting, strenuous exercise and sexual intercourse for the first six weeks. Once you begin to attempt sex again, you can ease the discomfort using over-the-counter lubricants.

The time needed off work varies from patient to patient and will depend upon your own circumstances, the type of job you do and the extent of your surgery. Your doctor will be able to discuss this all with you and provide you with a more accurate estimate.

Success rates

Around 80-90% of sacrospinous fixation surgeries and ileococcygeus suspension surgeries are successful. In some patients, however, prolapse can return or affect a different area of the vagina. In these cases, additional surgery might be necessary.

Complications

All surgeries carry risks. We discuss the common complications which can arise with any type of surgery, as well as those specific to Sacrospinous fixation or Ileococcygeus suspension.

General complications after any surgery:

  • Anaesthetic issues – this is very rare nowadays.
  • Excessive bleeding which requires a blood transfusion is very uncommon after a vaginal surgery.
  • Infections of the vagina or pelvic are. This is noticeable by a strong odour from vaginal discharge, as well as pelvic pain, fever or abdominal pain. You should seek medical attention immediately if you experience any of these side-effects.
  • Cystitis, which is a bladder infection, and affects about 6% of women after surgery. It is more common in those who have had the catheter fitted though.

Complications related to this surgery in particular:

  • Around 1 in 10 women will experience a pain in their buttocks for several weeks after the surgical procedure. Pain medication is prescribed to help ease it. Some people may also notice a stabbing or burning sensation in their rectum, which should ease shortly afterwards.
  • Constipation is common in many people after this surgery and your doctor can prescribe you with laxatives to help, as well as recommending a high-fibre diet with lots of liquids.
  • Painful or uncomfortable sex may occur in some women, whilst others report a much more comfortable sex life after the procedure to fix their prolapse.