Guidance
3 The procedure
3 The procedure
3.1 Infracoccygeal sacropexy is usually done with the patient under general or regional anaesthesia. An incision is made in the posterior wall of the vagina and a small puncture incision is made in each buttock. A mesh tape is introduced through 1 buttock incision and using a tunnelling device, guided by a finger through the vaginal incision, the mesh is passed around the rectum. The mesh is then passed up the side of the vagina, across the top, and out through the incision in the other buttock. Both ends are cut so that they end just below the surface of the skin. The mesh is sutured to the top of the vagina and acts as a tension-free sling to suspend the uterus in its natural position. The procedure is sometimes described as posterior intravaginal slingplasty.
3.2 This procedure can be combined with hysterectomy or surgery for stress urinary incontinence, such as a suburethral sling placement.
3.3 Several different types of synthetic and biological mesh are available that vary in structure and in their physical properties, such as absorbability.