Posthysterectomy vault prolapse: sacral colpopexy with dura mater graft

Vaginal vault prolapse is an infrequent complication after abdominal and vaginal hysterectomy. Current surgical methods of repair include transvaginal fixation of the vault to the sacrospinous ligament, repositioning of the vagina over the levator plate by a synchronous abdominoperineal procedure, and transabdominal sacral colpopexy. Because each method results in a durable repair and restores a functional vagina, sacral colpopexy is considered the preferred procedure because of its technical simplicity. The proposed advantages using dura mater as the prosthesis are detailed.