Related Experiment Video
Updated: Mar 6, 2026
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Transvaginal iliococcygeus fixation for posthysterectomy vaginal vault prolapse repair
Rodolfo Milani1, Matteo Frigerio1, Federico Spelzini2
1San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Introduction And Hypothesis:
Posthysterectomy vaginal vault prolapse repair is a surgical challenge. Successful surgical management using native tissue can be achieved via the vaginal approach by iliococcygeus fascia fixation. However, although iliococcygeus fascia fixation is technically simple and has a low morbidity, it is not commonly performed. The aim of the video is to provide anatomic views and the surgical steps necessary to achieve successful transvaginal iliococcygeus fascia fixation for vaginal vault prolapse repair.
Methods:
A 60-year-old woman with symptomatic stage III vaginal vault prolapse was admitted for transvaginal iliococcygeus fascia fixation according to the described technique.
Results:
Surgery was successful without complications. The final examination showed good apical support and preservation of vaginal length. This step-by-step video tutorial may be an important tool to improve practical surgical knowledge. In particular, proper suture positioning requires adequate pararectal space preparation and levator ani exposure, as shown in the video.
Conclusions:
Transvaginal iliococcygeus fascia fixation is an alternative technique for apical support without the use of synthetic prosthetic materials. This technique may be indicated when an abdominal approach or a synthetic device is not recommended.
