DR. MAYANK MOHAN AGARWAL
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Vaginal hysterectomy with uterosacral ligament suspension

What is a uterosacral ligament suspension?

A uterosacral ligament suspension is a surgical procedure that restores the support of the top of the vagina after hysterectomy. It can be performed at the same time as hysterectomy, or later on in life in women who have previously undergone through a hysterectomy. In this surgery, the top of the vagina is stitched to the uterosacral ligaments (which are strong supportive structures that run between the bones of the pelvis and the sacrum), thereby restoring its support. Anatomically, the vagina returns back to its original position. This type of prolapse procedure is referred to as a “native tissue repair” as the patients tissue is utilized to restore the support of the vagina.

How is the surgery performed?

Urogynecologist will perform the uterosacral ligament suspension through a minimally invasive surgical (MIS) route; the most common way to perform it is through the vagina, however, it can also be done utilizing conventional laparoscopy and the robotic surgical system. The patient and urogynecologist will determine which MIS route is right for you. Regardless of the route you choose, the surgery can be performed under general anesthesia with an anesthesiologist monitoring your heart and lung function throughout the surgery. If you are having a hysterectomy performed, your urogynecologist will perform this first. After this, the top part of your vagina had to be sewn to the ligaments using both permanent and delayed-absorbable stitches. Oftentimes, this surgery is performed at the same time as an incontinence surgery to treat urinary incontinence.

What is the recovery?

Since your urogynecologist is able to perform this surgery utilizing a minimally invasive procedure, you will most likely be able to go home the day of surgery. This surgery is done to restore your quality of life, and thus would get you doing the things you want to do as quickly as possible postoperatively. Sexual intercourse for at least 6 weeks has to be abstained while your stitches in your vagina are healing. Otherwise, you can return to your normal activities as soon as you feel ready.