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Management of post-hysterectomy vaginal vault prolapse using posterior intravaginal slingplasty

Department of Obstetrics and Gynaecology, Basildon University Hospital, Nethermayne, Basildon, SS16 5NL, UK. email: yatin98{at}hotmail.com (corresponding author)

Rajiv Varma, FRCOG, Consultant

Department of Pelvic Reconstructive Surgery, Basildon University Hospital, Basildon, UK.

The aims of surgery for post-hysterectomy vaginal vault prolapse are to correct the anatomical defects, preserve vaginal function and improve symptoms with as low a risk of recurrence as possible. The techniques currently in use are: sacrospinous ligament fixation, McCall culdoplasty and abdominal or laparoscopic sacrocolpopexy. None of these procedures is 100% successful. Posterior intravaginal slingplasty is a new technique in which a neo-uterosacral ligament is formed using a polypropylene tape. The procedure appears to have similar efficacy to those currently in use but with minimal surgical morbidity. It is easy to perform after training and there is good medium-term outcome. Further long-term follow-up and randomised controlled trials are required to compare it with existing procedures but the preliminary results are very encouraging.

Keywords Keywords / Post-hysterectomy vaginal prolapse / posterior intravaginal slingplasty