An effective and safe innovation for the management of vault prolapse

51 cases of post- hysterectomy vault prolapse: 45 following vaginal and 6 after total abdominal hysterectomy were treated surgically by anterior abdominal wall colpopexy with autogenous rectus fascia strips.Except for minor complaints like vomiting, fever and urinary retention in 3.92% cases each (n = 2 each), no major complications were encountered. Moreover, no recurrence, thus far, on follow-up.Using autogenous rectus fascia strips in anterior abdominal wall colpopexy is not only simple, cheap and effective method of treating apical prolapse but is also devoid of any serious complications as described with other techniques.Post-hysterectomy apical (vault) prolapse is referred to as the descent of the vaginal vault/cuff scar below a point that is 2 cm less than the total vaginal length above the plane of the hymen [1]. This condition is shown to follow 11.6% of hysterectomies performed vaginally for prolapse and 1.8% of those performed abdominally for other indications[2]. Several surgical procedures have been described for the treatment of vault prolapse and given the available evidence of complications and limitations of each, it is difficult to recommend one technique over the other[3]. Regarding vault suspension to the anterior abdominal wall, enough studies are not available to assess its efficacy.In the period between May 2002 and July 2008, 51 cases of vaginal vault prolapse were treated with the innovative technique described hereunder.88.23% (n = 45) had had undergone vaginal hysterectomy for genital prolapse and the remaining 11.77% (n = 6) had apical prolapse developing after abdominal hysterectomy for the indication of leiomyoma uteri in 4 cases and dysfunctional uterine bleeding in the other 2 cases. The mean time elapsed from the previous surgery was 29 months with the shortest being 13 months and the longest being 50 months. Two of the cases of vaginal hysterectomy group had undergone prior surgery for the vault prolapse- one had sacrocolpopexy 13 m