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4. Postoperative
Heparin was continued until complete patient mobilization and 
the bladder catheter was maintained for 24 h postoperatively. 
Patients were discharged after 3 days in Group A and C and 
after 2 days in Group B.
We evaluated the primary outcome with the POP-Q system. 
The secondary outcome was evaluated for recurrent vaginal vault 
prolapse to the introitus or beyond it and for symptom resolution. 
Each patient was seen 1 month, 3 months and then annually 
after the procedure.
Changes in symptoms were classiied as resolved, persistent, 
or new onset from baseline to the last follow-up visit.
Results
From February 2005 to January 2009 we treated 28 patients. 
Demographics and clinical characteristics are presented in 
Table 1. Mean age and standard deviation (SD) at enrollment 
was 49,93 (4,19) years, with a range of 42-58 years. Ten of 
the patients presented a history of hysterectomy, but none 
with previous pelvic loor surgery. In Group A six patients 
delivered twice, ive once and one for three times. In Group 
B ive patients delivered twice and one once and in Group 
C six patients delivered twice, two once and two for three 
times. We performed vaginal vault reconstruction with LSH 
in 12 patients, with TLH in six patients and in ten patients 
with a history of hysterectomy. In two of the cases, in Group 
A, additionally we performed TVT for stress incontinence, 
which was diagnosed through urodynamic examination. The 
vaginal prolapse was completely treated in all patients and no 
recurrences were observed after a follow-up of 36 months. We 
recorded six cases (three in Group A, one in Group B and two 
in Group C) with abdominal pain, presenting one week after 
surgery, at the level of the placement of the trocars (Table 3). 
It was successfully resolved with 50mg of Ketonal repeated 
twice a day for one week. In one of the cases, in Group B, 
urinary retention in the amount of 200ml was noticed. This 
was resolved by the introduction of a Foley catheter for 24 
hours. We encountered nor bladder nor rectal perforation, 
blood transfusions, infections, pelvic hematomas, deep vein 
thrombosis or pulmonary embolisms.
Three patients in Group A and two in Group C were pre-
menopausal. Six in nine patients in Group A received hormonal 
replacement therapy, compared to 2 and one patient in Groups 
B and C.