Surgical Decision-Making: Who Should Be Offered Sacrocolpopexy?

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Women undergoing surgery for apical pelvic organ prolapse have several medically sound options for specific surgical approaches. We review the principles of shared decision-making as they pertain to surgery for prolapse. We review the literature supporting the superior sacrocolpopexy as a durable treatment for prolapse and the factors that may differentiate it from other repairs in risk and benefit. We emphasize the importance of collaboration between patients and surgeons in surgical decision-making. All medically appropriate patients who desire reconstructive surgery for prolapse should be offered sacrocolpopexy.