Transvaginal levator myorraphy for vaginal vault prolapse

The progressive development of vaginal pain or pressure in women with vaginal vault prolapse and the frequent presence of accompanying lower urinary tract symptoms or bowel symptoms often ultimately result in the desire for treatment. Proper repair of vault prolapse will not only restore vaginal position and function, but also result in an improvement of pelvic symp- toms. Though conservative measures such as colpocleisis or pessaries may be appropriate to consider in a subset of women who are less fit for surgery, most active women desire an inter- vention that will not preclude or interfere with intercourse. Surgical procedures offer the best hope of a permanent correction, and several techniques have been described, including both abdominal (1,2) and vaginal approaches (3,4).