A 65 year old woman presented with vault prolapse. Many years previously she had had a hysterectomy. She reported a stable bladder.
After physical examination the treatment pathway was apparent.
She underwent Laparoscopic Mesh Sacral Colpopexy. The bladder is reflected off the vaginal vault. The mesh was sutured to the vaginal apex and tacked to the sacral promontory.
The patient made an excellent recovery. Follow up confirmed the vagina was well supported.
Vaginal prolapse seen laparoscopically
Bladder reflected from the vagina
Dissection posteriorly (for later attachment of mesh)
Mesh is laid over anterior vagina
Mesh is sutured to anterior and posterior vagina
At the end of the operation. The mesh has been tacked to the Sacral Promontory