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Cited by 12Pelvic floor disorders treatmentsUterine Myomas and TreatmentsHernia repair and management

Sacrocolpopexy: The Way I Do It

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Shahid, Usama, Chen, Zhouran, Maher, Christopher·2024·International Urogynecology Journal
DOI 10.1007/s00192-024-05922-0PMC PMC11638296
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Abstract

Introduction and Hypothesis: Sacrocolpopexy (SCP) is an established surgical procedure for apical vaginal vault prolapse. There remains significant variation amongst surgeons in both the surgical steps and concomitant surgeries utilised when undertaking an SCP. Methods: This review article is aimed at summarising the evidence and providing a detailed update of SCP in modern practice, reviewing contemporary evidence behind its indications, efficacy, outcomes, surgical steps, and complications. Results: Sacrocolpopexy remains the gold standard for post-hysterectomy apical prolapse based on good long-term outcomes, patient satisfaction and low complication rates. SCP with concomitant total hysterectomy is not recommended owing to high rates of mesh exposure. The laparoscopic approach remains the preferred option in terms of low morbidity, quicker recovery and lower cost than alternative access options. For optimal outcomes an SCP should be performed with monofilament mesh, using absorbable sutures and with a paravaginal repair for cystocele. Conclusions: Although SCP has become increasingly utilised for apical prolapse, its established efficacy regarding anatomical outcomes, patient satisfaction, and complications is in the context of post-hysterectomy prolapse. SCP with concomitant total hysterectomy has higher rates of mesh exposure. The efficacy and safety of SCP with sub-total hysterectomy or hysteropexy have not been clearly established and require further assessment through well-designed, rigorous randomised controlled trials.

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Authors
Shahid, U., Chen, Z., & Maher, C.
Affiliations
  • Royal Brisbane and Women's Hospital (AU)
  • The University of Queensland (AU)
Corresponding author
Shahid, Usama
ORCID
Maher, Christopher
Venue
International Urogynecology Journal
Publisher
Springer Science and Business Media LLC
Published
2024-10-15
Volume
35
Issue
11
Pages
2107-2123
ISSN
  • 0937-3462 (ISSN-L)
  • 1433-3023
DOI
10.1007/s00192-024-05922-0
PMC
PMC11638296
OpenAlex
W4403426468
Cited by
12
References
111
Citations by year
2026: 5 · 2025: 6 · 2024: 1
FWCI
0.89
Type
journal article
Language
en
Open access
Licence
Locations
  • International Urogynecology Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • ResearchOnline at James Cook University (James Cook University) (submittedVersion, cc-by)
Funders
James Cook University
Topics
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
  • Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
  • Health Sciences › Medicine › Surgery › Hernia repair and management
Keywords
sacrocolpopexy, total hysterectomy, mesh exposure, laparoscopic surgery, paravaginal repair, cystocele, hysteropexy, surgical indications, surgical outcomes, surgical complications
MeSH terms
Female, Humans, Hysterectomy, Laparoscopy, Postoperative Complications, Sacrum, Gynecologic Surgical Procedures, Surgical Mesh, Vagina, Treatment Outcome, Patient Satisfaction, Pelvic Organ Prolapse

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