ABSTRACT
The surgical treatment of vaginal vault prolapse and cervical or uterine prolapse is a major challenge to the surgeon, especially when preservation of sexual function is sought. In patients with surgical contraindications, the placement of a vaginal pessary may offer great relief from symptoms without any surgical risk. Genital prolapse can be treated by various techniques, with or without synthetic material, by laparotomy, laparoscopy, or a vaginal approach. In vaginal surgery, hysterectomy is usually associated with the technique, except in case of transposition of the uterosacral ligaments in front of the cervix. Fixation of the mesh to the vagina can be done either vaginally or laparoscopically using the tacking technique, but the vaginal route is preferred because it allows quick repair of enterocele. Vaginal eversion and uterine prolapse are a result of disruption of the upper paracolpium, which includes the fibro-muscular tissue of the cardinal and uterosacral ligaments.
