A 62-year-old woman presents with post-hysterectomy vaginal vault prolapse. She is medically fit and wants a definitive abdominal procedure with the best long-term anatomical success. Which is the most appropriate operation?

• A Abdominal sacrocolpopexy ✓
• B Anterior colporrhaphy with perineorrhaphy
• C Le Fort colpocleisis
• D McCall culdoplasty

Explanation

Abdominal sacrocolpopexy attaches the vaginal vault to the sacral promontory with a mesh bridge and has the highest long-term anatomical cure rate for vault prolapse, making it the gold standard in a fit woman wanting an abdominal approach. Anterior colporrhaphy does not address the vault defect. Le Fort colpocleisis is reserved for women who are unfit or sexually inactive. McCall culdoplasty is performed at the time of vaginal hysterectomy to prevent subsequent enterocele.

Reference: Berek and Novak's Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.