Transvaginal correction of posthysterectomy enterocele and vaginal vault prolapse

Aim: to evaluate the efficacy of transvaginal correction of posthysterectomy apical prolapse and enterocele using bilateral sacrospinous colpopexy with the implantation of one or two mesh prostheses Materials and Methods: a prospective study included 8 female patients diagnosed with apical prolapse and enterocele of stage III or higher who, between 2021 and 2024, underwent transvaginal correction of prolapse and enterocele utilizing either one or two mesh implants. Assessment comprised analysis of obstetric-gynecologic history, menopause duration, as well as duration of hormone replacement therapy (HRT) Patient- reported outcomes were evaluated using validated questionnaires: Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ- 12), Pelvic Floor Distress Inventory (PFDI-20), and Pelvic Floor Impact Questionnaire (PFIQ-7) The degree of prolapse was determined using the Pelvic Organ Prolapse Quantification (POP-Q) system. Results: of the 8 female patients included, 6 underwent transvaginal correction of enterocele with two mesh implants (tape plus wide mesh), and 2 patients were managed with a single implant (tape). The mean follow-up period was 21.3±2.4 months. No recurrences of prolapse were observed during follow-up Surgical correction resulted in a significant reduction of both dysuria and obstructive defecation symptoms There were no complications exceeding Clavien-Dindo grade I No cases of postoperative pelvic pain were reported Conclusion: our analysis demonstrates that transvaginal correction of posthysterectomy prolapse and enterocele utilizing polypropylene mesh implants is an effective and safe technique This method can be considered as an alternative to abdominal sacrocolpopexy for the treatment of enterocele, particularly in elderly and comorbid patients. KEYWORDS: enterocele; posthysterectomy prolapse; urogenital prolapse; pelvic organ prolapse; apical prolapse; transvaginal correction; polypropylene mesh; mesh surgery. FOR CITATION: Snurnitsyna O.V., Nikitin A.N., Slobodyanyuk B.A., Shpikina A.D., Babaevskaya D.I., Lobanov M.V., Rapoport L.M., Enikeev M.E., Dobrokhotova Yu.E. Transvaginal correction of posthysterectomy enterocele and vaginal vault prolapse. Russian Medical Inquiry. 2025;9(4):205–213 (in Russ.). DOI: 10.32364/2587-6821-2025-9-4-4