A 58-year-old sexually active woman presents with symptomatic post-hysterectomy vault prolapse. She wants definitive surgical correction. Which procedure has the highest reported long-term success rate for apical vault prolapse?

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

Explanation

Abdominal or laparoscopic sacrocolpopexy, attaching the vaginal vault to the sacral promontory with a mesh bridge, is the gold standard for vault prolapse, with success rates above 90 percent and durable anatomical results. Colpocleisis obliterates the vaginal canal and is unsuitable in a sexually active woman. McCall culdoplasty addresses the enterocele at the time of vaginal hysterectomy rather than established vault prolapse.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.