Sacrospinous fixation for the treatment and prevention of vaginal vault prolapse

Vaginal vault prolapse is an important complication that may occur after vaginal or abdominal hysterectomy. In this study 66 patients underwent a transvaginal sacrospinous fixation either for correction of vaginal vault prolapse (n = 33) or for prophylactic suspension of the apex, at the time of vaginal hysterectomy, in patients with severe utero-vaginal prolapse (n = 33). Results show that after an average time of follow-up of 30 months, the overall rate of anatomic success was more than 80%. The analysis of the vaginal profile shows that the anterior vaginal wall is affected by a higher rate of recurrence, with excellent results observed only in 44% of the patients. Stress urinary incontinence was objectivated with a cough stress test in 26 subjects before surgery, and a 65% cure rate was achieved with different antincontinence procedures.