title: Laparoscopic Management of Vaginal Vault Prolapse Recurring after Pelvic Organ Prolapse Surgery.
abstract: BACKGROUND
  Despite the increasing success of surgery for pelvic organ prolapse, recurrent vaginal vault prolapse is not rare. We present a step-by-step laparoscopic approach with a sacral colpopexy (SC) for treatment of recurrent vault prolapse.
  
  
  METHODS
  From 2006, 25 women presenting with symptomatic recurrent vault prolapse were prospectively evaluated and treated with laparoscopic SC. This article briefly describes all of the steps that are required to conduct a proper surgery in such cases.
  
  
  RESULTS
  After previous abdominal sacropexy, both the dissection of adherences and restoration of normal pelvic anatomy were challenging. As result, the overall operating time was longer in patients who had undergone abdominal sacropexy vs. vaginal route, p = 0.032. No significant peri- or postoperative complications were observed. At a mean follow-up of 41 months, all women presented with less than stage 2 prolapse and high levels of satisfaction.
  
  
  CONCLUSIONS
  Despite the need for an intraoperative step-by-step surgical safety checklist, the laparoscopic repair of recurrent vault prolapse is technically feasible, safe and effective.
authors.affiliation: Department of Urology, Perugia Hospital, Perugia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Mearini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Nunzi
authors.forename: Manuel
authors.initials: M
authors.lastname: Di Biase
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
mesh_terms: D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D012447:Sacrum