Prolapse of the vagina after hysterectomy

Twenty-two patients were operated upon for posthysterectomy vaginal prolapse. The original operation had been abdominal hysterectomy in 11 patients and vaginal hysterectomy in an additional 11 patients. All of the corrective operations were performed abdominally. Vaginal sacropexy was performed upon eight patients with our own modified method using a fascial strip taken from the rectum sheath. Dexon sutures were used in the attachment of the strip to the apex of the vagina and to the periosteum of the sacrum. The fascial strip was peritonealized. A high resection of the enterocele sac was performed. Excellent permanent vaginal support was achieved in all of these patients. Other methods of operation used included direct fixation of the vaginal apex to the presacral fascia, fixation of the vagina with round ligaments and the method according to Williams and Richardson. More than one-half of the patients had recurrences.