Vaginal Vault Prolapse: Lateral Fixation

The posterior vaginal wall and the rectovaginal septum are dissected first from the rectum. The peritoneum is incised in the midline between the uterosacral ligaments and the rectum is cleaved from the vagina and the rectovaginal fascia. The extent of the dissection is dependent on the size of the rectocele, and is continued until it reaches the lower part of the defect. In the presence of perineal muscles defects a posterior colpoper-ineorrhaphy with rectovaginal fascia repair, using the vaginal approach. Perioperative antibiotic therapy is systematically prescribed. The patient is allowed to leave the hospital as soon as micturition and passage of gas have resumed normally. Although laparoscopic lateral utero-vaginal suspension permits the association of a hysterectomy, the procedure is particularly indicated for women presenting predominantly with a uterine prolapse and cystocele and and who wish to have a conservative surgical treatment.