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Sacrospinous fixation

Vault prolapse, or uterine prolapse (hysteropexy).

Source: Standard operative texts

Key steps

  1. Usually right-sided via posterior approach into the pararectal space.
  2. Two sutures through the ligament ~2 cm medial to the ischial spine (protects pudendal vessels & nerve).
  3. Tie to the vault / cervix.
Buttock pain is common and usually settles; recurrence of anterior prolapse can occur.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.