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Urogynaecology · UK

Sacrohysteropexy - a uterus‑preserving lift for prolapse.

A laparoscopic or robotic operation that lifts the uterus back into its proper place without removing it - a durable, evidence‑based apical repair for women who want to keep the uterus, whether for future pregnancy, personal reasons, or simply because it is healthy.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private sacrohysteropexy costs in the UK.

Indicative ranges across our partner urogynaecology units.

In short

£10,500–£15,500, home after one night.

Procedure Indicative range
Laparoscopic sacrohysteropexy £10,500–£15,500
Robotic‑assisted sacrohysteropexy £14,000–£20,000
Sacrohysteropexy with concomitant colporrhaphy £12,500–£17,500
Sacrohysteropexy with Burch/mid‑urethral sling £13,500–£19,000
Laparoscopic sacrocolpopexy (post‑hysterectomy) £11,000–£16,000
Vaginal sacrospinous hysteropexy (alternative) £7,500–£11,500
Manchester procedure (alternative) £7,000–£10,500
Urogynaecology consultation only £280–£475

Prices vary by hospital, by consultant, by approach (laparoscopic or robotic), and by whether a concomitant repair or continence procedure is done at the same sitting. On the NHS, subspecialist sacropexy currently carries a 6–14 month wait in most regions.

The problem

The right lift, the right conversation, and a repair that lasts.

Prolapse pathways still default to hysterectomy too often - and mesh anxiety has left many women stuck on pessaries they hate. Both need fixing before you consent.

  • Ask before removing

    A healthy uterus does not have to come out to fix a prolapse. Uterine preservation is an evidence‑based choice - not a compromise.

  • Abdominal mesh is not the transvaginal story

    Sacrohysteropexy places mesh abdominally in a very different plane. Complication rates are much lower - you deserve the honest numbers.

  • Plan for pregnancy, if it might matter

    If children are still on the horizon, that changes the operation and the delivery plan. We build it in from day one, not day of surgery.

When it helps

When sacrohysteropexy is the right step.

The situations we see most, plus the one red flag that means endometrial assessment urgently rather than a routine prolapse booking.

  • Symptomatic uterine (apical) prolapse

    A visible bulge, a dragging sensation, or a lump you can feel at the introitus - with the uterus itself as the leading edge on examination.

  • Younger women, family not complete

    Uterine preservation matters if future pregnancy is on the table. Sacrohysteropexy is one of the few durable options that keeps that door open.

  • Personal preference to keep the uterus

    Cultural, emotional or identity reasons to preserve the uterus are valid and common. A uterus‑preserving procedure should be offered on request, not fought for.

  • Failed conservative therapy

    Pelvic floor physiotherapy and a properly fitted pessary have not held things, or you have decided a pessary is not for you long‑term.

  • Recurrence after vaginal repair

    A previous vaginal repair has come down again - an abdominal sacropexy is more durable at the apex, particularly for POP‑Q stage 3 or 4.

  • Combined pelvic floor defects

    Apical prolapse alongside a large cystocele or rectocele - sacrohysteropexy can be paired with anterior or posterior repair in the same sitting.

  • Occupational or sexual‑function priorities

    Vaginal length and calibre matter more for some patients than others. Abdominal sacropexy preserves both better than most vaginal apical repairs.

  • Red flag: postmenopausal bleeding

    Any bleeding after menopause needs endometrial assessment first, whatever the prolapse story is - that is a two‑week‑wait pathway, not a booking on the operating list.

Procedure options

Approach and adjuncts depend on your prolapse pattern.

What each option involves - laparoscopic, robotic, vaginal‑route uterus preservation, and the concomitant repairs that often go with sacrohysteropexy.

  • Laparoscopic sacrohysteropexy

    The most common private route in the UK. A polypropylene mesh strap runs from the anterior cervix (± posterior vagina) to the sacral promontory, lifting the uterus. 90–150 minutes, one night.

  • Robotic‑assisted sacrohysteropexy

    Da Vinci platform. Adds precision for dense adhesions, deep pouch of Douglas, higher BMI, or when combined with concomitant repair. Outcomes match laparoscopic in experienced hands.

  • Vaginal sacrospinous hysteropexy

    A vaginal‑route uterus‑preserving option using non‑absorbable sutures to fix the cervix to the sacrospinous ligament. No abdominal mesh, but slightly higher recurrence.

  • Manchester (Fothergill) procedure

    Uterine preservation by amputating the elongated cervix and shortening the cardinal ligaments. Traditional, low‑cost, cannot be used if future pregnancy is planned.

  • Uterosacral or cervicosacropexy variants

    Uterus fixed to the uterosacral ligaments or to the anterior longitudinal ligament of the sacrum without a formal Y‑mesh - used in select anatomies.

  • With anterior or posterior colporrhaphy

    Sacrohysteropexy addresses the apex. Cystocele or rectocele may need a same‑sitting vaginal repair - done through the vagina, no additional mesh.

  • With continence surgery

    Occult stress incontinence may unmask after apical repair. A concomitant mid‑urethral sling or Burch colposuspension is discussed when urodynamics justifies it.

  • Sacrocolpopexy (post‑hysterectomy)

    If the uterus is not present, the same operation is called sacrocolpopexy - the vaginal vault, not the cervix, is suspended to the sacrum. Same durability profile.

Safety and recovery

What to expect afterwards - honestly.

Sacrohysteropexy is well established and durable. The things worth planning are mesh consent, concomitant repairs, and - for those who might yet conceive - a pregnancy plan.

  • GA in a proper theatre, with a specialist team

    Every route is under general anaesthetic with head‑down positioning. Day‑case is uncommon - most patients stay one night; robotic and combined cases may be two.

  • Bleeding at the sacral promontory

    Injury to the middle sacral vessels or presacral venous plexus is rare (<1%) but the reason experience matters. Blood transfusion is needed in around 1% of cases.

  • Ureter, bladder and bowel injury

    Each under 1% with an experienced urogynaecologist. The team is set up to recognise and repair on the table. Ureteric stents are used selectively.

  • Mesh exposure and pain

    Vaginal mesh exposure after abdominal sacropexy runs at around 2–4% at 5 years, lower than transvaginal mesh. Persistent pelvic pain from mesh is uncommon but is a proper informed‑consent point.

  • Recurrent prolapse - the honest number

    Anatomical success at the apex is 85–95% at 5 years - durable, but not universal. Recurrence at other compartments (anterior, posterior) is more common than at the apex itself.

  • De novo stress incontinence

    Lifting the apex can unmask latent stress incontinence in 10–20% of patients. Preoperative urodynamics and a clear plan for post‑op continence surgery keep this manageable.

  • Constipation, urinary urgency, sexual function

    Some patients notice new‑onset urgency or straining. Sexual function is preserved or improved in most, but dyspareunia occurs in a small minority - always ask.

  • Pregnancy after sacrohysteropexy

    Pregnancy is possible but should be planned with the surgical team. Delivery is usually by elective caesarean at 38–39 weeks to protect the mesh support.

  • Red flags after surgery

    Fever, spreading redness, heavy vaginal discharge or bleeding, calf pain, breathlessness or unable to pass urine after catheter removal need same‑day team review, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever approach was used - laparoscopic or robotic - the note the urogynaecologist sends you keeps to the same shape.

A UK consultant urogynaecologist reviewing a patient’s sacrohysteropexy notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the mesh product used before your review, just ask.

  1. 01 Header

    Approach, extent and mesh

    Laparoscopic or robotic, whether the mesh strap ran to the anterior cervix alone or included the posterior vagina, and the mesh product used.

  2. 02 Technique

    Anatomy, adhesions, adjuncts

    What was seen inside the pelvis - pouch of Douglas depth, adhesions, endometriosis - and whether a concomitant anterior or posterior repair or sling was performed.

  3. 03 Findings

    Fixation and closure

    How the mesh was fixed to the sacral promontory and to the cervix, and how the peritoneum was closed over the mesh to reduce bowel adhesion risk.

  4. 04 Impression

    Follow‑up, recurrence risk, pregnancy plan

    Read this first: your six‑week and annual follow‑up schedule, expected recurrence risk, and - if relevant - the plan for pregnancy and caesarean delivery.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Sacrohysteropexy is usually covered when symptomatic apical prolapse is documented and conservative therapy has been trialled or declined. Robotic approach may need specific pre‑authorisation.

Frequently asked

Everything we get asked about sacrohysteropexy.

Quick answers on mesh, alternatives, pregnancy, cost and recovery.

  • What is sacrohysteropexy, in plain English?

    A keyhole (or robotic) operation that lifts a prolapsing uterus by attaching a soft polypropylene mesh strap between the front of the cervix and the sacral promontory - the bony ridge at the top of the tailbone. The uterus is left in place. It is one of the most durable apical repairs available.

  • Why keep the uterus rather than just do a hysterectomy?

    Uterine preservation matters for many reasons - future pregnancy, cultural or personal identity, or simply because there is no gynaecological reason to remove a healthy organ. Long‑term data show sacrohysteropexy achieves apical support comparable to sacrocolpopexy after hysterectomy, without the added recovery, blood loss and operative time of the hysterectomy itself.

  • Is the mesh the same mesh that was banned?

    No. The NHS England pause applies to transvaginal mesh - mesh inserted through the vagina to repair anterior or posterior compartment prolapse. Sacrohysteropexy places a mesh strap abdominally, above the peritoneum, in a completely different plane. Abdominal sacropexy mesh remains supported by RCOG and BSUG for symptomatic apical prolapse, with much lower complication rates than the transvaginal route. You should still have a full mesh conversation before you consent.

  • What is the alternative to sacrohysteropexy if I want to keep my uterus?

    The main alternatives are vaginal sacrospinous hysteropexy (fixing the cervix to a pelvic ligament via the vagina, with sutures rather than mesh) and the Manchester procedure (cervical amputation and cardinal‑ligament shortening - cannot be used if pregnancy is planned). Both avoid abdominal mesh but carry a slightly higher recurrence rate at the apex.

  • Can I still have a baby afterwards?

    Yes. Pregnancy after sacrohysteropexy is possible and there is a growing body of case series with reassuring outcomes. Delivery is almost always by planned caesarean at 38–39 weeks to protect the mesh support.

  • How much does a private sacrohysteropexy cost in the UK?

    Roughly £10,500–£15,500 for laparoscopic and £14,000–£20,000 for robotic, all‑inclusive of consultant fee, theatre, mesh, one‑night stay and six‑week review. Concomitant anterior/posterior repair adds £2,000–£3,000; a mid‑urethral sling adds around £2,500. On the NHS, waiting times for subspecialist sacropexy currently sit at 6–14 months in most regions.

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