Sacrocolpopexy for treatment of vaginal apical prolapse: evidence-based surgery

Pelvic organ prolapse is a common condition that negatively affects womens' quality of life. Sacrocolpopexy is an abdominal procedure designed to treat apical compartment prolapse including uterine or vaginal vault prolapse and multiple-compartment prolapse. Although traditionally performed as an open abdominal procedure, minimally invasive sacrocolpopexy, whether laparoscopic or robotic, has been successfully adopted in the practice of many pelvic reconstructive surgeons. There are many variations to this procedure, with different levels of evidence to support each of them. Herein we review the current literature on sacrocolpopexy, with emphasis on the minimally invasive approach. Procedural steps and controversies are examined in light of the existing literature, and recommendations are made on the basis of the level of existing evidence.