Guidance
Evidence-based recommendations on bilateral cervicosacropexy (CESA) or vaginosacropexy (VASA) using mesh for pelvic organ prolapse in adults. This involves replacing weakened or stretched ligaments that support the uterus and hold the pelvic organs in place with mesh tape.
In July 2018, the Government announced a period of ‘high vigilance restriction’ on the use of a group of procedures, including this procedure, to treat stress urinary incontinence and pelvic organ prolapse, in England. This followed a recommendation by Baroness Cumberlege, who is chairing an independent review of surgical mesh procedures and has heard from women and families affected by them. For details, see the letter from NHS England and NHS Improvement to trust medical directors. The high vigilance restriction period was extended in March 2019. In April 2019, we updated our guideline on urinary incontinence and pelvic organ prolapse and published patient decision aids to support people to make informed decisions about surgery for stress urinary incontinence, uterine prolapse and vaginal vault prolapse.
Is this guidance up to date?
Next review: March 2023
Guidance development process
How we develop NICE interventional procedures guidance
Coding and clinical classification codes for this guidance