Information for the public

Benefits and risks

Benefits and risks

When NICE looked at the evidence, it decided that sacrocolpopexy using mesh to repair vaginal vault prolapse works well enough. There are serious but well-known risks with the procedure. The 10 studies that NICE looked at involved a total of 5,790 patients. NICE also got comments from 14 women who had the procedure.

Generally, they showed the following benefits of the procedure compared with other procedures:

  • better success rate

  • less likelihood of prolapse happening again

  • improved quality of life at 12 and 60 months after the procedure

  • 83% of women were quite satisfied with the procedure and 55% of women would recommend it

  • 13 of the 14 women who commented on their procedure would recommend it

  • improved symptoms, with reduced pelvic pressure and the feeling of needing to open the bowels

  • sex less painful and less difficult.

Rates of constipation, difficulty opening the bowels and a feeling of needing to go urgently were slightly higher 43 months after the procedure, with an increase of between 2% and 6%.

The studies showed that most of the risks of sacrocolpopexy using mesh to repair vaginal vault prolapse were similar to or lower than those reported after repair using the woman's own tissue. Other risks included:

  • mesh or suture complications in up to 4% of women; mesh erosion was up to 14% more common in women who had their womb and cervix removed than in those whose cervix remained

  • another operation for stress urinary incontinence was needed in up to 19%

  • stress incontinence in up to 38% of women who had not had this before

  • problems in passing urine in up to 13%

  • needing to pass urine urgently with incontinence in up to 8% of women who had not had this before

  • painful or difficult sex in up to 24% of women who had not had this before

  • rectal prolapse in up to 12% of women who had not had this before

  • bladder prolapse in up to 8% of women who had not had this before

  • urinary tract or bladder injury in up to 2%

  • small bowel obstruction in up to 3%

  • pain going down the leg from the lower back in 3%.

NICE was also told about some other possible risks: infection of the sacrum (the bone at the base of the spine) and bleeding from large abdominal blood vessels.

If you want to know more about the studies, see the guidance. Ask your health professional to explain anything you don't understand.

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