n South African Journal of Obstetrics and Gynaecology - Vault prolapse treated by sacrocolpopexy

Volume 13, Issue 3
  • ISSN : 0038-2329
  • E-ISSN: 2078-5135



To evaluate the success rate of sacrocolpopexy in 153 patients with stage 3 and 4 vault prolapse.

A retrospective review was done on 153 patient records from a database in a urogynaecological unit. For the sacrocolpopexy procedure, semi-absorbable mesh was placed along the anterior and posterior vaginal walls, and attached to the anterior longitudinal ligament of the sacrum.
The median age was 65 years and parity 3.0; 94% of the patients were white. Previous surgery for prolapse was reported by 48% of the patients and 25% were on thyroid hormone treatment. The vault prolapse was stage 3 in 81 patients (52.9%) and stage 4 in 72 (47.1%). At surgery, the mesh extended from the vaginal vault to the sacrum in 7 patients (4.6%). In the remaining 146 patients (95.4%) the mesh was attached to the posterior vaginal wall and in 133 (86.9%) a second strip of mesh was fixed to the anterior vaginal wall. Follow-up was possible in 149 patients (97.4%), with a median of 29 months. Recurrent prolapse (any type) occurred in 22 patients (14.4%) and 12 had repeat surgery for recurrent prolapse (7.8%). In total, 25 patients (16.3%) had repeat surgery for any indication.
Vault prolapse is difficult to treat owing to absence of support of the upper vagina, but sacrocolpopexy delivered acceptable results.

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