Introduction: Despite the increasing success of surgery for pelvic organ prolapse, recurrent vaginal vault prolapse is not rare. We present a step-by-step laparoscopic approach with a sacral colpopexy (SC) for treatment of recurrent vault prolapse. Materials and Methods: From 2006, 25 women presenting with symptomatic recurrent vault prolapse were prospectively evaluated and treated with laparoscopic SC. This article briefly describes all of the steps that are required to conduct a proper surgery in such cases. Results: After previous abdominal sacropexy, both the dissection of adherences and restoration of normal pelvic anatomy were challenging. As result, the overall operating time was longer in patients who had undergone abdominal sacropexy vs. vaginal route, p = 0.032. No significant peri- or postoperative complications were observed. At a mean follow-up of 41 months, all women presented with less than stage 2 prolapse and high levels of satisfaction. Conclusions: Despite the need for an intraoperative step-by-step surgical safety checklist, the laparoscopic repair of recurrent vault prolapse is technically feasible, safe and effective.

1.
Barber MD, Maher C: Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J 2013;24:1783-1790.
2.
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN: An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 2010;21:5-26.
3.
Dällenbach P, Kaelin-Gambirasio I, Jacob S, Dubuisson JB, Boulvain M: Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct 2008;19:1623-1629.
4.
Cooper J, Annappa M, Dracocardos D, Cooper W, Muller S, Mallen C: Prevalence of genital prolapse symptoms in primary care: a cross-sectional survey. Int Urogynecol J 2015;26:505-510.
5.
Anderson KM, Davis K, Flynn BJ: Urinary incontinence and pelvic organ prolapse. Med Clin North Am 2015;99:405-416.
6.
Adjoussou SA, Bohoussou E, Bastide S, Letouzey V, Fatton B, de Tayrac R: [Functional symptoms and associations of women with genital prolapse]. Prog Urol 2014;24:511-517.
7.
Lowenstein L, Gamble T, Sanses TV, van Raalte H, Carberry C, Jakus S, Kambiss S, McAchran S, Pham T, Aschkenazi S, Hoskey K, Kenton K; Fellow's Pelvic Research Network: Sexual function is related to body image perception in women with pelvic organ prolapse. J Sex Med 2009;6:2286-2291.
8.
Aponte MM, Rosenblum N: Repair of pelvic organ prolapse: what is the goal? Curr Urol Rep 2014;15:385.
10.
Barber MD, Maher C: Apical prolapse. Int Urogynecol J 2013;24:1815-1833.
11.
Haya N, Maher M, Ballard E: Surgical management of recurrent upper vaginal prolapse following sacral colpopexy. Int Urogynecol J 2015;26:1243-1245.
12.
Schmid C, O'Rourke P, Maher C: Laparoscopic sacrocolpopexy for recurrent pelvic organ prolapse after failed transvaginal polypropylene mesh surgery. Int Urogynecol J 2013;24:763-767.
13.
Mettu JR, Colaco M, Badlani GH: Evidence-based outcomes for mesh-based surgery for pelvic organ prolapse. Curr Opin Urol 2014;24:370-374.
14.
Denman MA, Gregory WT, Boyles SH, Smith V, Edwards SR, Clark AL: Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 2008;198:555.e1-e5.
15.
Withagen MI, Milani AL, de Leeuw JW, Vierhout ME: Development of de novo prolapse in untreated vaginal compartments after prolapse repair with and without mesh: a secondary analysis of a randomised controlled trial. BJOG 2012;119:354-360.
16.
Withagen MI, Vierhout ME, Milani AL: Does trocar-guided tension-free vaginal mesh (Prolift) repair provoke prolapse of the unaffected compartments? Int Urogynecol J 2010;21:271-278.
17.
Nygaard I, Brubaker L, Zyczynski HM, Cundiff G, Richter H, Gantz M, Fine P, Menefee S, Ridgeway B, Visco A, Warren LK, Zhang M, Meikle S: Long-term outcomes following abdominal sacrocolpopexy for pelvic organ prolapse. JAMA 2013;309:2016-2024.
18.
Unger CA, Walters MD, Ridgeway B, Jelovsek JE, Barber MD, Paraiso MF: Incidence of adverse events after uterosacral colpopexy for uterovaginal and posthysterectomy vault prolapse. Am J Obstet Gynecol 2015;212:603.e1-e7.
19.
Gilleran JP, Zimmern P: Abdominal mesh sacrocolpopexy for recurrent triple-compartment pelvic organ prolapse. BJU Int 2009;103:1090-1094.
20.
Norinho de Oliveira P, Bourdel N, Rabischong B, Canis M, Botchorishvili R: What to do with recurrent prolapse after vaginal mesh failure? J Minim Invasive Gynecol 2015;pii:S1553-4650(15)01554-X.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.