Case series of abdominal sacral colpopexy

Vandana Dhama, Shakun Singh, Rachna Chaudhary, Haripriya Bajwa


Background: Abdominal sacral colpopexy is a transabdominal procedure that suspends vaginal vault to the sacrum using natural or synthetic graft material. We can perform this procedure in patients who have Post hysterectomy vault prolapse. Primary indication of this procedure is to resuspend a prolapsed vaginal apex. Secondary indications include repair of the cystocele, posterior vaginal wall and apical segment descent. The goal of this study was to assess the complications of repair of post hysterectomy vaginal vault proplase with polypropylene mesh.

Methods: This study was conducted on 8 patients scheduled to undergo abdominal sacral colpopexy in SVBP Hospital associated to LLRM Medical College, Meerut, UP, India from March 2011 to March 2016 who had vault prolapse after hysterectomy. When patients complained of something coming out of vagina, pelvic examination was done by consultant in OPD during valsalva manoeuvre and per speculum examination. Pelvic organ prolapse quantification classification was used to classify prolapse. Two consultants performed all operations based on a standardized surgical technique.

Results: In our study, all patients were followed for up to one year (at 3 months, 6 months, one year) after surgery for following observations- recurrence of prolapse, mesh erosion, dyspareunia, lower abdominal pain, constipation. None of the patient had above complaints in the follow up period.

Conclusions: Abdominal sacral colpopexy with polypropylene mesh is a safe, effective treatment in patients having post hysterectomy vaginal vault proplase. When done by experienced gynecologist, major post-operative complications seem to be very few in patients having normal BMI & no major systemic illnesses.


Vaginal vault prolapse, Polypropylene mesh, Abdominal sacral colpopexy

Full Text:



Lane FE. Repair of post hysterectomy vaginal-vault prolapse. Obstet Gynecol. 1962;20:72.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29:4-20.

Mant J, Painter R. Epidemiology of genital prolapse: observations from the oxford family planning association study. British Journal of Obstetrics and Gynaecology. 1997;104(5):579-85.

Marchionni M, Bracco GL. True incidence of vaginal vault prolapse: thirteen years of experience. Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 1999;44(8):679-84.

Paraiso MFR, Walters MD, Rackley RR. Laparoscopic and abdominal sacral colpopexies: a comparative cohort study. American Journal of Obstetrics and Gynecology. 2005;192(5):1752-8.

Snyder TE, Krantz KE. Abdominal-retroperitoneal sacral colpopexy for the correction of vaginal prolapse. Obstetrics and Gynecology. 1991;77(6):944-9.

Timmons MC, Addison WA. Abdominal sacral colpopexy in 163 women with post hysterectomy vaginal vault prolapse and enterocele: evolution of operative techniques. Journal of Reproductive Medicine for the Obstetrician and Gynecologist. 1992;37(4):323-7.

Muhlendorf IK, Browning GM. Vaginal length and sexual function after colpopexy for complete uterovaginal eversion. Am J Obstet Gynecol. 1993;169(2 Pt 1):284-7.

Velanovich V. Laparoscopic versus open surgery: a preliminary comparison of quality-of-life outcomes. Surg Endosc. 2000;14(1):16-21.

Freeman RM, Pantazis K. A randomized controlled trial of abdominal versus laparoscopic sacrocolpopexy for the treatment of post-hysterectomy vaginal vault prolapse: LAS study. International Urogynecology Journal. 2013;24(3):377-84.

Klauschie JL, Suozzi BA, O'Brien MM. A comparison of laparoscopic and abdominal sacral colpopexy: objective outcome and perioperative differences. International Urogynecology Journal and Pelvic Floor Dysfunction. 2009;20(3):273-9.

Beer M, Kuhn A. Surgical techniques for vault prolapse: a review of the literature. Eur J Obstet Gynecol Reprod Biol. 2005;119:144.