The abdominal sacral colpopexy is performed in patients with vaginal vault prolapse. Laparoscopic abdominal sacral colpopexy is performed using several small incisions. A synthetic mesh is used to support the vagina to the sacral promontory inside the pelvis.
Prior to surgery you will be asked to do a bowel prep and a clear liquid diet.
- Magnesium Citrate
What to expect after surgery
- You will have an overnight stay at the hospital, during this time you will have vaginal packing and a foley catheter.
- You will be expected to do breathing exercises called incentive spirometry to prevent respiratory infections.
- On the day after surgery it is very important to get out of bed and begin walking. This will help prevent Deep Vein Thrombosis (DVT). Please follow the DVT prevention handout.
- If you are unable to urinate the next morning after your procedure you may go home with a catheter.
- You will be instructed to follow up with your provider in 1 to 2 weeks for catheter removal.
- You may have vaginal bleeding for up to 4 to 6 weeks. If you are saturating more than 4-5 pads per day you should be seen in clinic.
- Your bowels may be sluggish after surgery and pain medication can increase constipation. Follow the postoperative bowel program instructions for the next 6 weeks. It is very important to avoid straining post sling placement.
- You may shower when you go home do not bathe or sit in a hot tub for 2 to 3 weeks.
- You will have steri strip over your incision and these will fall off in 5-7 days.
- You can use a heating pad on the incision to help with muscle soreness.
- Use your pain medication as directed if needed.
- Activities and postoperative restrictions
- You should reduce your activity level for the first 6 weeks while healing.
- Walking and light exercise is important in preventing Deep Vein Thrombosis.
- Use stairs gently for the first 2 to 3 weeks.
- No heavy lifting, pushing, or pulling over 10 lbs for 6 weeks.
- No sexual intercourse for 6 weeks.
- No strenuous exercising for 6 weeks.
- Try to avoid severe straining during bowel movements and follow the post-op bowel program daily for the next 6 weeks.
- Do not drive for the first 2 to 3 weeks after surgery. Do not drive while taking narcotics.
- You should resume your pre-surgery medication unless told otherwise.
- Do not take any aspirin products for the first two weeks.
- If you are taking Warfrin or Plavix this should be followed by your primary care provider postoperatively. They will discuss with you when to resume medication and dosing recommendations
- If you are taking pain medication or iron supplements you should also be taking a stool softener to keep the stool soft.
- If your pain is mild you can stop taking the pain medication and switch to acetaminophen.
- In addition, you should be following the postoperative bowel program and using vaginal estrogen.
Medications to have at home before surgery:
- Stool softener
- Milk of Magnesia
- Magnesium Citrate
- Vaginal Estrogen if applicable
You may return to your normal diet. You may want to avoid acidic foods and drinks that may cause burning with urination. Drinks with caffeine may cause frequency and irritation to your bladder. If not on a sugar or salt restricted diet drink 8 to 10 glasses of water and Gatorade daily to avoid constipation and prevent possible urinary tract infections.
- Fever over 101 Fahrenheit by mouth
- Pain not relieved by medication
- Rash, itching after taking pain medication
- Continued nausea and vomiting
- Abnormal swelling around operative site
- Increased redness, warmth, hardness around operative site
- Excessive drainage from surgical site
- Excessive bleeding from operative site (small amounts of oozing may be normal)
- Inability to urinate
- Swelling of the calf, ankle or foot
- Increased warmth of the leg
- Pain in the leg
- Bluish discoloration of the skin or leg
Postoperative follow up
You will need a follow-up appointment to monitor your progress in 6 weeks postoperatively. You will be called for a postoperative follow up 1 to 2 days after surgery and you can make your postoperative appointment at that time or by calling and speaking to a receptionist. If you have a catheter your follow up appointment will typically be within 1 to 2 weeks after surgery and again in 6 weeks.