Infracoccygeal sacropexy using mesh to repair vaginal vault prolapse

Infracoccygeal sacropexy is done with the patient under regional or general anaesthesia. An incision is made in the posterior wall of the vagina and a small puncture incision is made in each buttock. A mesh tape is introduced through 1 buttock incision and, using a tunnelling device, guided by a finger through the vaginal incision, the mesh is passed around the rectum. The mesh is then passed up the side of the vagina, across the top, and down the other side, and out through the incision in the other buttock. Both ends are cut so that they end just below the surface of the skin. The mesh is sutured to the top of the vagina to act as a tension-free sling that aims to support the vaginal vault. The procedure is sometimes described as posterior intravaginal slingplasty.

This procedure can be combined with surgery for stress urinary incontinence, such as a sub-urethral sling placement.

Several different types of synthetic and biological mesh are available that vary in structure and in physical properties such as absorbability.