[The Williams-Richardson vaginopexy as a surgical therapy in vaginal inversion in vaginal stump prolapse]

Genuine prolapse of the vaginal stump following total hysterectomy, which must be differentiated from the relatively frequent vaginal descent after hysterectomy usually not requiring additional surgery, is generally a rare positional anomaly of the female genitalia and is by no means easy to correct. This phenomenon requires special surgery to restore or preserve the ability to have intercourse. The article discusses the surgical techniques described in international literature which are suitable for correcting a prolapse of the vaginal stump. Basing on 31 patients treated by the authors, the advantages offered by vaginopexy after Williams and Richardson in the treatment of vaginal inversion following hysterectomy are discussed. In spite of the relatively limited number of patients, the results followed up about three years after surgical correction justify recommending this still rarely employed procedure. Its advantages are: secure fixation of the prolapsed vault of the vagina with nearly optimal anatomic and functional restoration of the vagina, maintained or regained ability to have intercourse, considerable and nearly complete freedom from subjective complaints, and obviously also a low likelihood of relapse.