Robert MacDermott - Consultant Gynaecologist
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  KIMS Hospital
  Kent, ME14 5FT
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Sacrospinous Fixation (SSF)

This leaflet is written for women who are thinking of having a Sacrospinous Fixation (SSF) operation.

 What is a sacrospinous fixation?
It is an operation to treat prolapse of the womb and/or vagina. The aim of the operation is to attach the upper vagina and/or cervix to the sacrospinous ligament. This ligament is part of the pelvic floor.

 How is the operation performed?
An incision is made in the upper part of the posterior (back) vaginal wall. Through this incision, the sacrospinous ligament is identified and 2 stitches are used to fix the upper vagina or cervix to the ligament.

This operation is usually performed together with other operations to treat prolapse. These include vaginal hysterectomy and vaginal repairs. I will explain which combination of operations are necessary to treat your type of prolapse.

 What are the alternative treatments for my prolapse?
Prolapse can be treated using a pessary device which sits in the vagina. These are usually changed every 4-6 months. The drawback of a pessary is that is often not possible to have satisfactory sexual intercourse.

An alternative treatment for prolapse after hysterectomy is Abdominal Sacrocolpopexy. This is a good operation but involves operating through an incision in the abdomen. It is a bigger operation and has a higher complication rate than a Sacrospinous Fixation.

A Sacrospinous Fixation can sometimes be used to avoid hysterectomy where the womb is prolapsing.

 What are the risks of surgery?
The risks of surgery depend mainly on the other operations that are performed at the same time as the Sacrospinous Fixation. The Sacrospinous Fixation itself may result in bleeding but major bleeding would be very rare.

The operation can result in buttock pain and this will affect around 1 in 12 women. This pain usually settles over the coming months. Long-term pain is very rare.

 Is the operation permanent?
A Sacrospinous Fixation has a good success rate but no operations for prolapse can be guaranteed to last for the rest of your life. The risk of requiring a second operation for prolapse in your lifetime is around 20%.

 When will I be able to return to work?
This will depend on the other procedures performed at the same time as the SSF. Most women need 8-12 weeks off work after surgery for prolapse. You should avoid heavy lifting during this time also.

Further information - If you require any further information, please ask me.

Author - Robert MacDermott February 2005

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