The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on insertion of mesh uterine suspension sling (including sacrohysteropexy) for uterine prolapse repair.

NICE was notified of various procedures for the treatment of pelvic organ prolapse. NICE asked the Review Body for Interventional Procedures to undertake a systematic review of these procedures. The Interventional Procedures Advisory Committee (IPAC) considered the systematic review and have also produced guidance on: sacrocolpopexy using mesh for vaginal vault prolapse repair, sacrocolpopexy using mesh for uterine prolapse repair, infracoccygeal sacropexy using mesh for vaginal vault prolapse repair and infracoccygeal sacropexy using mesh for uterine prolapse repair.

Description

Uterine prolapse occurs when the womb slips down from its normal position into the vagina. Uterine suspension sling involves an operation to insert a piece of material (mesh) with the aim of holding the womb in place.

Coding recommendations

One of the following OPCS-4 codes is selected as appropriate:

Q54.4 Suspension of uterus using mesh NEC

Q54.5 Sacrohysteropexy

Note: Code Y75.2 Laparoscopic approach to abdominal cavity NEC would also be recorded if the procedure was performed using a laparoscopic approach.

In addition ICD-10 code N81.2 Incomplete uterovaginal prolapse, N81.3 Complete uterovaginal prolapse or N81.4 Uterovaginal prolapse, unspecified is assigned.

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