Uterosacral and sacrospinous ligament suspension for restoration of apical vaginal support.

Correction of apical vaginal prolapse has been described via abdominal, laparoscopic, and transvaginal approaches. The uterosacral and sacrospinous ligament suspension procedures are common transvaginal native tissue repairs to restore apical vaginal support. Preoperative evaluation, operative decision making, surgical techniques, and objective and subjective outcomes of each technique are reviewed.