Follow-up after repair of vaginal vault prolapse with abdominal colposacropexy.

Background: Vaginal vault prolapse after hysterectomy is a rare complication, with a prevalence of less than 1/2%. The vaginal depth an axis can be restored by colposacropexy with preservation of coital function. The aim of this follow-up study was to assess the results of colposacropexy with special attention to recurrence of prolapse and urogenital symptoms.

Methods: During a 4-year period 35 patients with vault prolapse were operated by colposacropexy. At follow-up the patients were interviewed about bladder, bowel and sexual symptoms. A pelvic examination and measurement of residual urine was done. Perioperative complications and any interim surgery was recorded.

Results: The patients were multioperated, because of prolapse or incontinence prior to colposacropexy. No serious perioperative complications were seen, except one case of severe bleeding from the presacral veins. Subjectively, 82% were cured of prolapse symptoms, one had recurrent vault prolapse and was reoperated, four had rectocele. Five patients developed urge incontinence, while urge incontinence, frequency, nocturia and voiding problems were cured in 75%, 80%, 50% and 100%, respectively. One patient developed fecal incontinence. No patients had coital problems due to the colposacropexy. Three patients were reoperated because of intestinal obstruction.

Conclusion: Colposacropexy has a cure rate of vault prolapse of 97% (85 100%) and a positive effect on irritative bladder symptoms.