6 Training <strong>of</strong> those performing laparoscopic procedures.7 Addressing all vaginal wall defects.8 Rate <strong>of</strong> complications following various surgical procedures, including direct and indirect recurrencefollowing post-hysterectomy vault prolapse surgery, time to recurrence and the development <strong>of</strong> stressincontinence <strong>of</strong> urine following surgery for post-hysterectomy vaginal vault prolapse.9. Future research<strong>The</strong> prevention and management <strong>of</strong> post-hysterectomy vaginal vault prolapse requires large robust studiesthat include disease-specific QoL assessment as well as evaluation <strong>of</strong> objective and subjective outcomes,using standardised tools. Randomised controlled trials are needed to assess various approaches, includingnewly introduced surgical techniques.References1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, etal. Standardisation Sub-Committee <strong>of</strong> the InternationalContinence Society. <strong>The</strong> standardisation <strong>of</strong> terminology <strong>of</strong>lower urinary tract function: Report from the standardisationsub-committee <strong>of</strong> the International Continence Society.Neurourol Urodyn 2002;21:167–8.2. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO,Klarskov P, et al. <strong>The</strong> standardisation <strong>of</strong> terminology <strong>of</strong> femalepelvic organ prolapse and pelvic floor dysfunction. Am J ObstetGynecol 1996;175:10–7.3. Baden WF, Walker TA, Lindsey JH. <strong>The</strong> vaginal pr<strong>of</strong>ile. Tex Med1968;64:56–8.4. Marchionni M, Bracco GL, Checcucci V, Carabaneanu A, CocciaEM, Mecacci F, et al. True incidence <strong>of</strong> vaginal vault prolapse.Thirteen years experience. J Reprod Med 1999;44:679–84.5. Cruikshank SH, Kovac SR. Randomized comparison <strong>of</strong> threesurgical methods used at the time <strong>of</strong> vaginal hysterectomy toprevent posterior enterocele. Am J Obstet Gynecol 1999;180:859–65.6. McCall ML. <strong>Post</strong>erior culdoplasty; surgical correction <strong>of</strong>enterocele during vaginal hysterectomy: a preliminary report.Obstet Gynecol 1957;10:595–602.7. Wall LL. A technique for modified McCall culdeplasty at the time<strong>of</strong> abdominal hysterectomy. J Am Coll Surg 1994;178:507–9.8. Ostrzenski A. A new, simplified posterior culdoplasty andvaginal vault suspension during abdominal hysterectomy. Int JGynaecol Obstet 1995;49:25–34.9. Cruikshank SH. Preventing posthysterectomy vaginal vaultprolapse and enterocele during vaginal hysterectomy. Am JObstet Gynecol 1987;155:1433–40.10. Cruikshank SH, Cox DW. Sacrospinous ligament fixation at thetime <strong>of</strong> transvaginal hysterectomy. Am J Obstet Gynecol 1990;162:1611–19.11. Colombo M, Milani R. Sacrospinous ligament fixation andmodified McCall culdoplasty during vaginal hysterectomy foradvanced uterovaginal prolapse. Am J Obstet Gynecol 1998;79:13–20.12. Wall LL, Hewitt JK. Urodynamic characteristics <strong>of</strong> women withcomplete posthysterectomy vaginal vault prolapse. Urology1994;44:336–41.13. Cundiff GW, Harris RL, Coates K, Low VH, Bump RC, AddisonWA. Abdominal sacral colpoperineopexy: a new approach forcorrection <strong>of</strong> posterior compartment descent associated withvaginal vault prolapse. Am J Obstet Gynecol 1997;177 1345–55.14. Harris TA, Bent AE. Genital prolapse with and without urinaryincontinence. J Reprod Med 1990;35:792–8.15. Ross JW. Techniques <strong>of</strong> laparoscopic repair <strong>of</strong> total vault eversionafter hysterectomy. J Am Assoc Gynecol Laparosc 1997;4:173–83.16. Symmonds RE, Williams TJ, Lee RA, Webb MJ. <strong>Post</strong>hysterectomyenterocele and vaginal vault prolapse. Am J Obstet Gynecol1981;140:852–9.17. Morley GW, DeLancey JO. Sacrospinous ligament fixation foreversion <strong>of</strong> the vagina. Am J Obstet Gynecol 1988;158:872–81.18. Virtanen H, Hirvonen T, Makinen J, Kiilholma P. Outcome <strong>of</strong>thirty patients who underwent repair <strong>of</strong> posthysterectomyprolapse <strong>of</strong> the vaginal vault with abdominal sacral colpopexy.J Am Coll Surg 1994;178:283–7.19. Cruikshank SH, Muniz M. Outcomes study: a comparison <strong>of</strong>cure rates in 695 patients undergoing sacrospinous fixationalone and with other site-specific procedures: a 16-year study.Am J Obstet Gynecol 2003;188:1509–12.20. Hagen S, Stark D, Maher C, Adams E. Conservative management<strong>of</strong> pelvic organ prolapse in women. Cochrane Database SystRev 2006;4:CD003882.21. Cutner AS, Elneil S. <strong>The</strong> vaginal vault. BJOG 2004;111(Suppl 1):79–83.22. Toozs-Hobson P, Boos K, Cardozo L. <strong>Management</strong> <strong>of</strong> vaginalvault prolapse. BJOG 1998;105:13–17.23. Lemack GE, Zimmern PE, Blander DS. <strong>The</strong> levator myorraphyrepair for vaginal vault prolapse. Urology 2000;56(6 Suppl 1):50–4.24. Maher CF, Qatawneh AM, Dwyer PL, Carey MP, Cornish A,Schluter PJ. Abdominal sacral colpopexy or vaginal sacrospinouscolpopexy for vaginal vault prolapse: a prospective randomizedstudy. Am J Obstet Gynecol 2004;190:20–6.25. Brubaker L, Bump R, Fynes M, Jacquetin B, Karram M, Kreder K,et al. Surgery for pelvic organ prolapse. In: Abrams P, Cardozo L,Khoury S and Wein A, editors. Incontinence. 3rd ed. Paris: HealthPublications; 2005. p. 1371–40226. Benson JT, Lucente V, McClellan E. <strong>Vaginal</strong> versus abdominalreconstructive surgery for the treatment <strong>of</strong> pelvic supportdefects: a prospective randomized study with long-termoutcome evaluation. Am J Obstet Gynecol 1996;175:1418–22.27. Lo TS, Wang AC. Abdominal colposacropexy and sacrospinousligament suspension for severe uterovaginal prolapse: acomparison. J Gynecol Surg 1998;14:59–64.28. Sze EH, Meranus J, Kohli N, Miklos JR, Karram MM. <strong>Vaginal</strong>configuration on MRI after abdominal sacrocolpopexy andsacrospinous ligament suspension. Int Urogynecol J Pelv FloorDysfunct 2001;12:375–9.29. Rane A, Lim YN, Withey G, Muller R. Magnetic resonanceimaging findings following three different vaginal vaultprolapse repair procedures: a randomised controlled study. AustN Z J Obstet Gynaecol 2004;44:135–9.30. Hardiman PJ, Drutz HP. Sacrospinous vault suspension andabdominal colposacropexy: success rates and complications.Am J Obstet Gynecol 1996;17:612–16.31. Sze EH, Kohli N, Miklos JR, Roat T, Karram MM. A retrospectivecomparison <strong>of</strong> abdominal sacrocolpopexy with Burchcolposuspension versus sacrospinous fixation with transvaginalneedle suspension for the management <strong>of</strong> vaginal vault prolapseand coexisting stress incontinence. Int Urogynaecology J PelvicFloor Dysfunct 1999;10:390–3.RCOG Green-top Guideline No. 46 10 <strong>of</strong> 13
32. Brown WE, H<strong>of</strong>fman MS, Bouis PJ, Ingram JM, Hopes SL.<strong>Management</strong> <strong>of</strong> vaginal vault prolapse: retrospectivecomparison <strong>of</strong> abdominal versus vaginal approach. J Fl MedAssoc 1989;76:249–52.33. Maher C, Baessler K, Glazener CM, Adams EJ, Hagen S. Surgicalmanagement <strong>of</strong> pelvic organ prolapse in women. CochraneDatabase Syst Rev 2004;(4):CD004014.34. Randall CL, Nichols DH. Surgical treatment <strong>of</strong> vaginal inversion.Obstet Gynecol 1971;38:327–32.35. Marinkovic SP, Stanton SL. Triple compartment prolapse:sacrocolpopexy with anterior and posterior mesh extensions.BJOG 2003;110:323–6.36. Addison WA, Livengood CH, Sutton GP, Parker RT. Abdominalsacral colpopexy with Mersilene mesh in the retroperitonealposition in the management <strong>of</strong> posthysterectomy vaginal vaultprolapse and enterocele. Am J Obstet Gynecol 1985;153:140–6.37. Given FT, Muhlendorf IK, Browing GM. <strong>Vaginal</strong> length andsexual function after colpopexy for complete uterovaginaleversion. Am J Obstet Gynecol 1993;169:284–8.38. Holly RL, Varner RE, Gleason BP, Apffel LA, Scott S. Sexualfunction after sacrospinous ligament fixation for vaginal vaultprolapse. J Reprod Med 1996;41:255–8.39. Brubaker L, Cundiff GW, Fine P, Nygaard I, Richter HE, Visco AG, etal. Pelvic Floor Disorders Network. Abdominal sacrocolpopexywith Burch colposuspension to reduce urinary stressincontinence. New Engl J Med 2006;354:1557–66.40. Pohl JF, Frattarelli JL. Bilateral transvaginal sacrospinouscolpopexy: preliminary experience. Am J Obstet Gynecol 1997;177:1356–61.41. Shull BL, Capen CV, Riggs MW, Kuehl TJ. Bilateral attachment <strong>of</strong>the vaginal cuff to iliococcygeus fascia: an effective method <strong>of</strong>cuff suspension. Am J Obstet Gynecol 1993;168:1669–77.42. Inmon WB. Pelvic relaxation and repair including prolapse <strong>of</strong> thevagina following hysterectomy. South Med J 1963;56:577–82.43. Maher CF, Murray CJ, Carey MP, Dwyer PL, Ugoni AM.Iliococcygeus or sacrospinous fixation for vaginal vault prolapse.Obstet Gynecol 2001;98:40–4.44. Barber MD, Visco AG, Weidner AC, Amundsen CL, Bump RC.Bilateral uterosacral ligament vaginal vault suspension withsite-specific endopelvic fascia defect repair for treatment <strong>of</strong>pelvic organ prolapse. Am J Obstet Gynecol 2000;183:1402–11.45. Shull BL, Bach<strong>of</strong>en C, Coates KW, Kuehl TJ. A transvaginalapproach to repair <strong>of</strong> apical and other associated sites <strong>of</strong> pelvicorgan prolapse with uterosacral ligaments. Am J Obstet Gynecol2000;183:1365–73.46. Karram M, Goldwasser S, Kleeman S, Steele A, Vassallo B, WalshP. High uterosacral vaginal vault suspension with fascialreconstruction for vaginal repair <strong>of</strong> enterocele and vaginal vaultprolapse. Am J Obstet Gynecol 2001;185:1339–43.47. Amundsen CL, Flynn BJ, Webster GD. Anatomical correction <strong>of</strong>vaginal vault prolapse by uterosacral ligament fixation in womenwho also required a pubovaginal sling. J Urol 2003;169:1770–4.48. Jenkins DT, McCoubrie SJF. <strong>Vault</strong> prolapse: a new approach. AustN Z J Surg 1992;62:805–8.49. Webb MJ, Aronson MP, Ferguson LK, Lee RA. <strong>Post</strong>hysterectomyvaginal vault prolapse: primary repair in 693 patients. ObstetGynecol 1998;92:281–5.50. Aronson MP, Aronson PK, Howard AE, Morse AN, Baker SP, YoungSB. Low risk <strong>of</strong> ureteral obstruction with ’deep‘ (dorsal/posterior)uterosacral ligament suture placement for transvaginal apicalsuspension. Am J Obstet Gynecol 2005;192:1530–6.51. Liu CY, Reich H. Correction <strong>of</strong> genital prolapse. J Endourol1996;10:259–65.52. Lyons TL, Winer WK. <strong>Vaginal</strong> vault suspension. Endosc SurgAllied Tech 1995;3:88–92.53. Margossian H, Walters MD, Falcone T. Laparoscopic management<strong>of</strong> pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol1999;85:57–62.54. Deval B, Haab F. What;s new in prolapse surgery? Curr OpinUrol 2003;13:315–23.55. Higgs PJ, Chua HL, Smith AR. Long term review <strong>of</strong> laparoscopicsacrocolpopexy. BJOG 2005;112:1134–8.56. Grundsell H, Larsson G. Operative management <strong>of</strong> vaginal vaultprolapse following hysterectomy. BJOG 1984;91:808–11.57. Paraiso MF, Falcone T, Walters MD. Laparoscopic surgery forenterocele, vaginal apex prolapse and rectocele. Int UrogynaecolJ Pelvic Floor Dysfunct 1999;10:223–9.58. Nezhat CH, Nezhat F, Nezhat C. Laparoscopic sacral colpopexyfor vaginal vault prolapse. Obstet Gynecol 1994;84:885–8.59. Mahendran D, Prashar S, Smith ARB, Murphy D. Laparoscopicsacrocolpopexy in the management <strong>of</strong> vaginal vault prolapse.Gynaecol Endosc 1996;5:217–22.60. Cosson M, Rajabally R, Bogaert E, Querleu D, Crépin G.Laparoscopic sacrocolpopexy, hysterectomy, and Burchcolposuspension: Feasibility and short-term complications <strong>of</strong>77 procedures. JSLS 2002;6:115–19.61. Carter JE, Winter M, Mendehlsohn S, Saye W, Richardson AC.<strong>Vaginal</strong> vault suspension and enterocele repair byRichardson–Saye laparoscopic technique: description <strong>of</strong>training technique and results. JSLS 2001;5:29–36.62. Dubuisson J. Laparoscopic management <strong>of</strong> genital prolapse:lateral suspension with two meshes. Gynaecol Endosc 2000;9:363–8.63. Lee CL, Wang CJ, Yen CF, Soong YK. Laparoscopicextraperitoneal sacrospinous suspension for vaginal vaultprolapse. Chang Gung Med J 2000;23:87–91.64. H<strong>of</strong>fman MS, Cardosi RJ, Lockhart J, Hall DC, Murphy SJ.Vaginectomy with pelvic herniorrhaphy for prolapse. Am JObstet Gynecol 2003;189:364–71.65. DeLancey JO, Morely GW. Total colpocleisis for vaginal eversion.Am J Obstet Gynecol 1997;176:1228–35.66. Harmanli OH, Dandolu V, Chatwani AJ, Grody MT. Totalcolpocleisis for severe pelvic organ prolapse. J Reprod Med2003;48:703–6.67. von Pechmann WS, Mutone M, Fyffe J, Hale DS. Total colpocleisiswith high levator plication for the treatment <strong>of</strong> advanced pelvicorgan prolapse. Am J Obstet Gynecol 2003;189:121–6.68. Pelosi MA, Pelosi MA. Transvaginal needle suspension withLeFort colpocleisis for stress incontinence and advanceduterovaginal prolapse in a high-risk patient. J Am Assoc GynecolLaparosc 1998;5:207–11.69. Cespedes RD, Winters JC, Ferguson KH. Colpocleisis for thetreatment <strong>of</strong> vaginal vault prolapse. Tech Urol 2001;7:152–60.70. Moore RD, Miklos JR. Colpocleisis and tension-free vaginal tapesling for severe uterine and vaginal prolapse and stressincontinence under local anaesthesia. J Am Assoc GynecolLaparosc 2003;10:276–80.71. Meschia M, Pifarotti P, Spennacchio M, Gattei U, Buonaguidid A.Randomized comparison between posterior IVS andsacrospinous fixation in the management <strong>of</strong> vault prolapse.Proceedings <strong>of</strong> the International Continence Society, 2003.72. Petros PE. <strong>Vault</strong> prolapse II: Restoration <strong>of</strong> dynamic vaginalsupports by infracoccygeal sacropexy, an axial day-case vaginalprocedure. Int Urogynecol J Pelvic Floor Dysfunct 2001;12:296–303.73. Farnsworth BN. <strong>Post</strong>erior intravaginal slingplasty (infraccoccygealsacropexy) for severe posthysterectomy vaginalvault prolapse: a preliminary report on efficacy and safety. IntUrogynaecol J Pelvic Floor Dysfunct 2002;13:4–8.74. Sivaslioglu AA, Gelisen O, Dolen I, Dede H, Dilbaz S, Haberal A.<strong>Post</strong>erior sling (infracoccygeal sacropexy): an alternativeprocedure for vault prolapse. Aust N Z J Obstet Gynaecol2005;45:159–60.75. Rane A, Lim YN, Withey G, Muller R. Magnetic resonanceimaging findings following three different vaginal vaultprolapse repair procedures: a randomised study. Aust N Z JObstet Gynaecol 2004;44:135–9.76. Baessler K, Hewson AD, Tun R, Schuessler B, Maher CF. Severemesh complications following intravaginal slingplasty. ObstetGynecol 2005;106:713–16.77. National Institute for Health and Clinical Excellence. <strong>Post</strong>eriorInfracoccygeal Sacropexy for <strong>Vaginal</strong> <strong>Vault</strong> <strong>Prolapse</strong>. InterventionalProcedure Guidance 125. London: National Institutefor Health and Clinical Excellence; 2005.11 <strong>of</strong> 13 RCOG Green-top Guideline No. 46