Surgical management of vaginal vault prolapse in a woman with a neovagina and pelvic kidneys.
BACKGROUND
Women with Mayer-Rokitansky-Kuster-Hauser syndrome have congenital absence of the uterus and upper two-thirds of the vagina, which is frequently accompanied by skeletal and renal anomalies. Mechanical dilation or surgical creation of a vagina allows for function but does not provide endopelvic fascial support of the vagina. Vaginal prolapse may occur.


METHODS
A 32-year-old woman presented with pelvic kidneys and a 5-year history of prolapse of her mechanically created neovagina. She underwent a sacrospinous ligament suspension with a cadaveric fascia lata bridge. The apex of the neovagina was 5 cm above the hymen 30 months postoperatively.


CONCLUSIONS
An allograft colpopexy to the sacrospinous ligament is an effective method of surgical treatment of women with a prolapsed shortened vagina and an inaccessible presacral space.
Muir
Tristi W
TW
Department of Obstetrics and Gynecology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA. muirtw@aol.com
Walters
Mark D
MD
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D003127:Colposcopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009095:Mullerian Ducts / Q000002:abnormalities; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000379:methods; D012008:Recurrence; D018570:Risk Assessment; D013577:Syndrome; D016896:Treatment Outcome; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000601:surgery; D014596:Uterine Prolapse / Q000175:diagnosis* / Q000601:surgery; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery*