Transvaginal sacrospinous colpopexy for vaginal vault and complete genital prolapse in aged women

Twenty-five women (mean age 72.8 years) with massive eversion of the vagina were treated with transvaginal sacrospinous ligament colpopexy between 1986 and 1990. Nine of them had a posthysterectomy vaginal prolapse; 16 had complete genital prolapse and coincident vaginal hysterectomy was performed. The operation was performed under spinal anesthesia in all cases except one with general anesthesia. Simultaneous anterior colporrhaphy was done in 88%, repair of enterocele in 72% and posterior colpoperineorrhaphy in 88% of all cases. There were no intra- or post-operative complications. Vaginal vault prolapse did not recur during a mean follow-up period of 2.8 years in 22 cases. Three patients developed asymptomatic cystocele or enterocele, and 5 (23%) women had a curtailed vagina. Sacrospinous ligament colpopexy under regional anesthesia is an effective and suitable operation for aged women with vaginal vault and complete genital prolapse. The operation is also a safe and fairly simple procedure if the anatomic relationship of the nearby structures is known.