Outcome of thirty patients who underwent repair of posthysterectomy prolapse of the vaginal vault with abdominal sacral colpopexy.

Thirty women experiencing posthysterectomy prolapse of the vaginal vault were treated with abdominal sacral colpopexy between 1984 and 1991. Lyodura (lyophilized cerebral dura mater allograft transplant) was used as the suspensory material in 81 percent and Gore-Tex (reinforced polytetrafluoroethylene) in 16 percent of the operations. There were no perioperative or postoperative complications. At the follow-up examination (mean, three years), good vaginal vault support was observed in 85 percent of the patients. Significant cystocele were seen in 18 percent, and vault prolapse, enterocele, rectocele and chronic perineal laceration each in 15 percent of the patients. At follow-up study, 22 percent of the patients experienced dyspareunia and 41 percent had decreased sexual interest and coital events. Development of stress urinary incontinence in 18 percent of patients was noted. Concomitant Burch colposuspension will cure and prevent stress incontinence and anterior vaginal relaxation. Abdominal sacral colpopexy appears to be a safe and effective method in the treatment of posthysterectomy prolapse of the vaginal vault. In our experience, it seems that coexistent cystocele and rectocele should be corrected in the connection with sacral colpopexy.