Current evidence on the safety and efficacy of sacrocolpopexy with hysterectomy using mesh to repair uterine prolapse is inadequate in quantity and quality. Therefore this procedure should only be used with special arrangements for clinical governance, consent and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.
Clinicians wishing to do sacrocolpopexy with hysterectomy using mesh to repair uterine prolapse should:
Inform the clinical governance leads in their trusts.
During the consent process, ensure that patients understand the uncertainty about the procedure's safety, including mesh erosion (for example, into the vagina) and the risk of recurrence, and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
Patient selection and treatment should only be done by specialists with experience in managing pelvic organ prolapse and urinary incontinence in women. All clinicians doing this procedure should have specific up-to-date training in the procedure.
Clinicians should enter details about all patients having sacrocolpopexy with hysterectomy using mesh to repair uterine prolapse onto an appropriate registry (for example, the British Society of Urogynaecology database). All adverse events involving the medical device used in this procedure should be reported to the Medicines and Healthcare products Regulatory Agency.
NICE may update the guidance on publication of further evidence.