ABSTRACT
Pelvic prolapse conditions have plagued women for thousands of years; however, it is only
recently that procedures have been developed that safely and effectively treat these conditions.
Even today, pelvic prolapse conditions remain a challenging problem, with vault prolapse
remaining the most difficult problem to treat because multiple support defects usually coexist.
A thorough understanding of pelvic anatomy, pathophysiology, and urodynamics and experi-
ence in selecting the appropriate surgical techniques are required to treat vault prolapse with
minimal morbidity or treatment failures. Although the goal of a vault prolapse procedure is to
restore normal anatomy and function in most cases, this is not always possible or necessary.
For the elderly, the medically unstable, and sexually inactive individual, it may be preferable
to simply “close off ” the vagina to maximize long-term results and minimize operative compli-
cations. These procedures, including colpocleisis and partial colpocleisis, are thought of
as “destructive” procedures and are currently unpopular; however, these procedures can be
extremely helpful in certain situations and should be in every reconstructive surgeon’s
armamentarium.
