[Reconstructive surgery of female pelvic floor prolapse]

It is recommended to perform pelvic floor prolapse surgery within a concept which bases on the women's symptoms, the expectations on life quality and functional aspects of the vagina, urinary bladder and rectum. Decisions on type of surgery must also be founded on the anatomical defect. An apical prolapse should either be fixed by sacrospinous ligament suspension or by sacrocolpopexy. In case of a cystocele the type of defect must be considered; a cystocele with a central defect can be corrected by anterior colporrhaphy whereas the cystocele caused by a paravaginal defect needs lateral fixation which today is increasingly done by vaginal mesh surgery. Rectocele repair is performed by posterior colporrhaphy. Knowledge of success and complication rates is essential for taking the right surgical decisions and for counselling the patient.