Sacrospinous Fixation

It is an operation that is performed through the vaginal route to support the vagina (after previous surgery to remove the womb) by attaching the top of it to the right sacrospinous ligament.

It is often not the only procedure that is done. It may be done concurrently with surgery to correct urinary incontinence, to remove the womb or to correct bladder or rectal prolapse in the vagina.

Why Is It Performed?

It is performed for severe protrusion of the vagina (after the womb was removed surgically).

The protrusion can bother you because of:

• A heavy dragging, sometimes painful sensation in the vagina
• An uncomfortable lump that can be felt or seen
• Urinary difficulties (e.g. incomplete emptying of the bladder)
• Bowel difficulties (e.g. constipation, incomplete emptying of the bowels)
• Pain
• Infection
• Bleeding

The objective of the operation is to relieve the symptoms, restore vaginal anatomy and sexual function.

How Do I Prepare Myself For The Operation?

1. Find out more about the procedure (e.g. by reading this pamphlet, you could be mentally and emotionally prepared for this operation).
2. Blood tests, an electrocardiography (ECG) and a chest X-ray may be done to ensure that you are in optimal health for the surgery.
3. A hormonal preparation containing estrogen (i.e. cream or pessaries) may be given to you before the operation if you are already menopausal. It is important to comply with this medication as it ensures that your vaginal tissues are optimal for healing after surgery.
4. You will generally be admitted one day before your surgery.
5. You will generally be given medical leave of 4 weeks to rest after operation.

​What Happens After Surgery?

1. After operation, you may experience:
   • Tiredness - you should rest and gradually increase your activity until you feel fit to return to your normal activities.
   • Some discomfort in the lower part of the abdomen - this is to be expected and painkillers should help to relieve the discomfort.
   • Vaginal bleeding - mild to moderate amount of reddish watery discharge up to 3 weeks after the operation is quite normal. You may want to wear a protective sanitary pad (not a tampon) during this period.
2. You should refrain from:
   • Strenuous exercise - until you are feeling fully fit. You may return to normal activity after 4 weeks.
   • Using tampons, douching or sexual intercourse over the next 4 weeks
3. You should return immediately to the Urogynaecology Centre (during office hours) or come to the O&G 24-hour Clinic if there is:
   • Heavy bright red vaginal bleeding
   • Foul smelling vaginal discharge
   • Severe abdominal distension and/or pain not relieved by painkillers
   • High fever
   • Pain on passing urine
   • Difficulty passing urine

When Do I Return For Follow-up

After the surgery, you will be seen at 1 week, 1 month, 6 months, 12 months and yearly thereafter. It is important to keep your follow-up appointments to ensure the best possible results.