ABSTRACT
Objective. To evaluate the success rate of sacrocolpopexy in 153 patients with stage 3 and 4 vault prolapse. Methods. 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. Results. The median age was 65 years and parity 3.0; 94of the patients were white. Previous surgery for prolapse was reported by 48of the patients and 25were 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 possiblein 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 anyindication. Conclusions. Vault prolapse is difficult to treat owing to absence of support of the upper vagina; but sacrocolpopexy delivered acceptable results