Minilaparoscopic sacrocolpopexy for vaginal prolapse after hysterectomy

Genital prolapse repair is one of the most common indications for benign gynecologic surgery. The lifetime risk of undergoing a single operation for prolapse in the female population is rising. Many different surgical techniques have been described. We report 4 cases of minilaparoscopic sacrocolpopexy to correct vaginal apical prolapse after previous total hysterectomy. For each patient we collected some socio-demographic data, vaginal apical prolapse grade using the Pelvic Organ Prolapse Quantification (POP-Q), intraoperative details and postoperative outcomes. Operative time was recorded as well as difficulties and complications (Clavien-Dindo Classification) at each step of the procedure. The range of women's ages was from 57 to 71 years old. The mean BMI was 24.75 ± 3.2 Kg/m2. Three patients had a stage III POP-Q prolapses and there was one case of a symptomatic stage II POP-Q prolapse. The mean surgical time was 119 minutes and there were no intraoperative complications. The postoperative pain assessment revealed very positive recovery in every patient. An ambulatory consult and an anatomic assessment were done 1 and 3 months after surgery. The incision scars were almost invisible after 1 month, and the anatomic cure rate was 100%. We confirmed the feasibility of a minilaparoscopic surgical approach for vaginal vault prolapse after total hysterectomy.