Robotic Sacrohysteropexy for Uterine Prolapse

Sacrohysteropexy lifts a prolapsed womb back into position and holds it there with a strip of permanent mesh running from the cervix to the strong ligament over the sacrum, the bone at the base of the spine. It is done by keyhole surgery, with or without the da Vinci robot.

It corrects the dragging bulge while keeping the uterus, with durable support of the top of the vagina. It uses abdominal mesh, which has a far lower complication rate than the vaginal mesh withdrawn in many countries but is still a permanent implant, and it does not by itself repair bladder or bowel wall prolapse.

What Robotic Sacrohysteropexy for Uterine Prolapse involves

Under general anaesthetic with you tilted head-down, four or five small ports are placed and the robot is docked. The surgeon opens the peritoneum over the sacral promontory, exposing the anterior longitudinal ligament while avoiding the nearby iliac veins, the right ureter and the middle sacral vessels. A tunnel is made beneath the peritoneum down the right side of the pelvis to the cervix. A polypropylene mesh, often Y-shaped or in two arms passed through windows in the broad ligaments, is stitched to the front and back of the cervix. The womb is lifted to the correct height without tension and the mesh tail is fixed to the sacral ligament with two or three permanent stitches or tacks. The peritoneum is closed over the mesh so that bowel cannot touch it. Vaginal wall repairs or a continence procedure may be added.

Who is a good candidate for Robotic Sacrohysteropexy for Uterine Prolapse?

A urogynaecologist stages the prolapse (POP-Q) and discusses pessaries and physiotherapy first.

• Symptomatic uterine prolapse of stage 2 or more
• Women who wish to keep their uterus
• Failure of or unwillingness to continue with a vaginal pessary
• Normal cervical screening, and a normal womb lining on ultrasound
• Younger, sexually active women, in whom abdominal suspension preserves vaginal length

It is usually not the right choice if:

• Abnormal uterine bleeding, large fibroids, abnormal smears or a raised risk of womb or ovarian cancer, where hysterectomy with vault suspension is usually preferable
• A very long cervix, which can mimic prolapse and needs a different repair
• Women planning pregnancy: data are limited, and caesarean delivery is usually advised afterwards
• Multiple previous abdominal operations with dense adhesions
• People unfit for 2 to 3 hours of head-down anaesthesia, for whom vaginal surgery suits better

Technique options

• Robotic sacrohysteropexy: Wristed instruments make suturing deep in the pelvis easier; outcomes equal those of laparoscopy.
• Laparoscopic sacrohysteropexy: The same operation without the robot, usually at lower cost.
• Vaginal sacrospinous hysteropexy: No mesh and no abdominal entry; a good native-tissue alternative.
• Hysterectomy with sacrocolpopexy: When the uterus should be removed.
• Manchester repair: Shortens an elongated cervix and tightens its ligaments.

What happens during your treatment

Surgery lasts 2 to 3 hours under general anaesthetic. A bladder catheter stays overnight. You walk the same evening and stay 1 to 2 nights, going home once you are passing urine well.

Preparing for your trip

Plan for 7 to 10 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Avoid lifting more than about 5 kg, straining and high-impact exercise for 6 weeks, and avoid intercourse for 6 weeks. Keep stools soft with fluids and a laxative. Desk work is possible at 2 to 3 weeks. Pelvic floor physiotherapy from 6 weeks helps to protect the repair. A review is held at 6 to 8 weeks, which can be at home if you take a detailed operation note that names the mesh.

• Back to everyday activity: 2 to 3 weeks for desk work; 6 weeks of restrictions
• When results show: The bulge is gone at once
• How long they last: Durable in about 85 to 90 in 100 at 5 years

Safety, risks and revision policy

Serious complications are uncommon, but you should understand the mesh-specific risks.

• Mesh exposure or erosion in about 1 to 3 in 100, lower than with hysterectomy-based mesh repairs
• Recurrent prolapse, often of the front vaginal wall, in roughly 10 in 100 over 5 years
• New or unmasked stress urinary incontinence
• Bleeding from the veins in front of the sacrum, which is rare but serious
• Injury to bowel, bladder or ureter
• Constipation, pain with intercourse or chronic pelvic pain
• Inflammation of the spinal disc at the fixation point, which is very rare

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Robotic Sacrohysteropexy for Uterine Prolapse in Türkiye

Clinic-Y does not publish a single price for Robotic Sacrohysteropexy for Uterine Prolapse, because the honest figure depends on your case. What moves it:

• Robotic or laparoscopic platform
• Additional vaginal repairs or a continence procedure
• Mesh type and fixation devices
• Length of stay
• Pre-operative tests such as urodynamics and ultrasound

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions