Vaginal anterior colposuspension (VACS) for cystocele

Posterior intravaginal slingplasty for vaginal prolapse

“…However, at the subsequent analysis of the success of this procedure, the recurrence rate of prolapse, particularly cystocele, was unacceptably high [9]. We no longer perform this procedure for the treatment of cystocele [9]. Although the overall recurrence for prolapse was high in this study (29%; grades 3 and 4), 17% of the patients suffered only from recurrent cystocele.…”

“…Amongst these is a procedure called "vaginal anterior colposuspension (VACS)." This is a locally developed procedure for cystocele repair [9]. A midline incision is made over the cystocele, and the vaginal walls are dissected away laterally.…”

“…Subsequent surgery was performed on six patients (14%): one posterior colporrhaphy (2%), two colposacropexies (5%), two VACS procedures (5%), four procedures One additional patient who had vault prolapse upon follow-up did not have apical prolapse during presentation The VACS is a locally developed procedure for cystocele performed vaginally and described elsewhere [9] for stress urinary incontinency (10%), and one colostomy (2%) for bowel pathology unrelated to the prolapse surgical procedure.…”

“…During the time of the study, we were developing and utilizing the VACS procedure. However, at the subsequent analysis of the success of this procedure, the recurrence rate of prolapse, particularly cystocele, was unacceptably high [9]. We no longer perform this procedure for the treatment of cystocele [9].…”

The use of graft materials in vaginal pelvic floor surgery

“…In contrast to other retrospective series, Cronje et al [21] showed a high rate of recurrence anterior wall prolapse (28.6%) using Vypro mesh (Johnson and Johnson, Brussels, Belgium) on 28 patients undergoing anterior colposuspension. Urinary retention was also reported in 7.1% leading the authors to conclude that mesh should not be recommended in cystocele repair.…”