Treatment of vaginal vault prolapse with abdominal sacral colpopexy using prolene mesh

We report our experience of abdominal sacral colpopexy (ASC) with a prolene mesh in women with total vaginal vault prolapse.

From 1994 to 1997, 15 patients (average age 57 years), underwent ASC. All the patients suffered from a serious vaginal vault prolapse. Eight of them also had a uterine prolapse. Seven patients had already been operated on for hysterectomy (5 vaginal, 2 abdominal), and 4 of them had already undergone an operation for urinary incontinence (3 Raz, 1 Burch). In 6 cases ASC was associated with a colposuspension in accordance with Burch. Average follow-up was 20 months.

All the patients carried a bladder catheter for 4 to 12 days (mean 5). The 11 patients who were sexually active began having normal sexual intercourse again. Neither relapses of the treated prolapses nor infection or rejections of the prostheses occurred. In 1 patient frequent micturition unresponsive to anticholinergics persisted. Four patients presented with hypogastric "sense of heaviness," with no clinical evidence of any pathology.

ASC with a prolene net is confirmed as the most valid technique, with no complications, in the treatment of total vaginal vault prolapse, above all when there is also the need for other operations via the abdomen at the same time (colposuspension, culdoplasty, and so forth), or when the vagina is too short to fix the sacrospinal ligament transvaginally.